Displaying 97411-97420 of 1611142 results.
ID:
97411
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1940654
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
97412
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1944382
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
97413
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1944376
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
97414
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1921081
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
30
ID:
97415
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1866047
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
97416
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1099026
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
97417
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1099269
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
97418
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1006065
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
97419
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1020155
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
91
Qty Limit Days:
84
ID:
97420
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1720616
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
97411974129741397414974159741697417974189741997420