Displaying 91381-91390 of 1611142 results.
ID:
91381
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
106303
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91382
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
313450
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91383
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
313451
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91384
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
308508
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91385
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
310149
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
4
ID:
91386
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1000673
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91387
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
284254
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91388
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
197900
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
91389
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
197901
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
91390
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
197902
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
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