Displaying 91701-91710 of 1611142 results.
ID:
91701
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
197848
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91702
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
855926
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
91703
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
855906
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
91704
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
855664
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
91705
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
995281
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91706
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1095227
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91707
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1304988
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91708
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1661092
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
91
Qty Limit Days:
84
ID:
91709
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
309079
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
91710
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1438778
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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