Displaying 93701-93710 of 1611142 results.
ID:
93701
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
2393794
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
540
Qty Limit Days:
30
ID:
93702
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
2121764
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
93703
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
2173841
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
93704
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1364477
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
93705
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1602028
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
93706
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1602034
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
93707
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1602040
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
93708
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
1602046
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
93709
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
2265729
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
93710
Formulary ID:
00021036
Formulary Version:
14
Contract Year:
2021
RXCUI:
2265732
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
93701937029370393704937059370693707937089370993710