Displaying 84401-84410 of 1611142 results.
ID:
84401
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049621
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
84402
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
2101899
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
84403
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049683
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
84404
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049686
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
84405
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1091150
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
84406
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
899557
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
84407
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
899518
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
84408
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
899548
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
84409
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1091133
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
900
Qty Limit Days:
30
ID:
84410
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
863664
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
84401844028440384404844058440684407844088440984410