Displaying 85721-85730 of 1611142 results.
ID:
85721
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
731568
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
85722
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
731571
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
85723
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
476872
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
85724
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049223
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
85725
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049227
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
85726
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049216
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
85727
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
854801
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
85728
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
313477
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
85729
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
861200
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
85730
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
861208
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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