Displaying 95501-95510 of 1611142 results.
ID:
95501
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
884189
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95502
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1099625
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95503
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
996571
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
95504
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
996561
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
95505
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
854916
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95506
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
854919
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95507
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
854908
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95508
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
201708
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95509
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
248420
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
95510
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
351172
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
95501955029550395504955059550695507955089550995510