Displaying 85101-85110 of 1611142 results.
ID:
85101
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
2100099
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
180
ID:
85102
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
2100100
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
180
ID:
85103
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
312614
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
85104
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
283077
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
85105
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
993755
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
4500
Qty Limit Days:
30
ID:
85106
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
197448
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
85107
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1923432
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
85108
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
578018
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
85109
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
477391
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
85110
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
197877
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
85101851028510385104851058510685107851088510985110