Displaying 92301-92310 of 1611142 results.
ID:
92301
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1242819
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
56
ID:
92302
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1242815
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
56
ID:
92303
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
616749
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
92304
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
728231
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
92305
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
2391560
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
92306
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1657212
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
92307
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1735537
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
92308
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
992403
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
92309
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1735496
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
92310
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1147228
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
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