Displaying 99021-99030 of 1611142 results.
ID:
99021
Formulary ID:
00021038
Formulary Version:
14
Contract Year:
2021
RXCUI:
861007
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
99022
Formulary ID:
00021038
Formulary Version:
14
Contract Year:
2021
RXCUI:
861010
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
99023
Formulary ID:
00021038
Formulary Version:
14
Contract Year:
2021
RXCUI:
861004
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
75
Qty Limit Days:
30
ID:
99024
Formulary ID:
00021038
Formulary Version:
14
Contract Year:
2021
RXCUI:
861731
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
99025
Formulary ID:
00021038
Formulary Version:
14
Contract Year:
2021
RXCUI:
562524
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
99026
Formulary ID:
00021038
Formulary Version:
14
Contract Year:
2021
RXCUI:
1652673
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
99027
Formulary ID:
00021038
Formulary Version:
14
Contract Year:
2021
RXCUI:
1649429
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
99028
Formulary ID:
00021038
Formulary Version:
14
Contract Year:
2021
RXCUI:
1650142
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
99029
Formulary ID:
00021038
Formulary Version:
14
Contract Year:
2021
RXCUI:
1650444
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
99030
Formulary ID:
00021038
Formulary Version:
14
Contract Year:
2021
RXCUI:
406524
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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