Displaying 96021-96030 of 1611142 results.
ID:
96021
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
2257013
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
84
Qty Limit Days:
28
ID:
96022
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1606870
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
28
ID:
96023
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
2053519
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
28
ID:
96024
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
2166401
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
28
ID:
96025
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1999389
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
28
ID:
96026
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1812470
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
96027
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1655934
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
96028
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
2053512
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
28
ID:
96029
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
904447
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
300
Qty Limit Days:
28
ID:
96030
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
904158
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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