Displaying 85961-85970 of 1611142 results.
ID:
85961
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
866111
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
85962
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
198252
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
85963
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1649593
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
ID:
85964
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1546189
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
ID:
85965
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
2261794
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
85966
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1040058
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
85967
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
858804
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
85968
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
794641
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
85969
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
902624
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
85970
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
902626
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
85961859628596385964859658596685967859688596985970