Displaying 84471-84480 of 1611142 results.
ID:
84471
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
808753
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
84472
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
808744
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
84473
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
861601
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
84474
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
861597
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
84475
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
615882
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
84476
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
284496
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
84477
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
197848
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
84478
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
855926
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
84479
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
855906
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
84480
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
855664
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
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