Displaying 90931-90940 of 1611142 results.
ID:
90931
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
284245
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
90932
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
835886
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
90933
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
866049
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
90934
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
896019
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
90935
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
896027
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
90936
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
896023
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
90937
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
213484
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
90938
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
759473
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
180
ID:
90939
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
896185
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
90940
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
896212
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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