Displaying 84021-84030 of 1611142 results.
ID:
84021
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
727575
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
84022
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1040012
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
84023
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1040016
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
84024
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1653470
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
84025
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1086776
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
84026
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1086780
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
84027
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1086786
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
84028
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1307415
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
84029
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1307421
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
84030
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1869699
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
84021840228402384024840258402684027840288402984030