Displaying 91401-91410 of 1611142 results.
ID:
91401
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
250344
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91402
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
722122
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
91403
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
722116
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
91404
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
198250
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91405
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
197502
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91406
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
863559
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91407
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1431286
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
91408
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
897612
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91409
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
897618
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91410
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
897624
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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