Displaying 95021-95030 of 1611142 results.
ID:
95021
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
897618
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95022
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
897624
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95023
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
897630
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95024
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
312025
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95025
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
198041
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95026
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
582926
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95027
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1597123
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
300
Qty Limit Days:
30
ID:
95028
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1597129
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
300
Qty Limit Days:
30
ID:
95029
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
238134
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
95030
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1745091
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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