Displaying 97021-97030 of 1611142 results.
ID:
97021
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
349592
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
97022
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
349593
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
97023
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1011736
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
97024
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1011739
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
97025
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
388311
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
97026
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
200133
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
97027
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
200131
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
97028
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
861237
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
97029
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
861221
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
97030
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
861223
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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