Displaying 96811-96820 of 1611142 results.
ID:
96811
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
2384465
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
5
Qty Limit Days:
28
ID:
96812
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1670324
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
80
Qty Limit Days:
28
ID:
96813
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1670322
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
100
Qty Limit Days:
28
ID:
96814
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
977923
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
96815
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
977929
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
96816
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
977874
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
96817
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
977894
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
96818
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
977902
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
96819
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
977909
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
96820
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
977915
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
96811968129681396814968159681696817968189681996820