Displaying 91301-91310 of 1611142 results.
ID:
91301
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
197634
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
91302
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
238154
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
91303
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
309844
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
1200
Qty Limit Days:
30
ID:
91304
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
865117
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91305
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
865123
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91306
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
860918
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91307
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
859841
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91308
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
313159
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
18
Qty Limit Days:
30
ID:
91309
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
197516
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91310
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
197517
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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