Displaying 95411-95420 of 1611142 results.
ID:
95411
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
861004
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
75
Qty Limit Days:
30
ID:
95412
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
861731
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
95413
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
562524
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95414
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1652673
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95415
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1649429
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95416
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1650142
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95417
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1650444
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95418
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
406524
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95419
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
434018
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95420
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
799048
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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