Displaying 95121-95130 of 1611142 results.
ID:
95121
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
562251
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95122
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
617995
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95123
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
198316
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95124
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
359296
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95125
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
308212
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95126
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
403810
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
95127
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
403811
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
95128
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1806195
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
95129
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1806179
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
95130
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1806183
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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