Displaying 86021-86030 of 1611142 results.
ID:
86021
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
199387
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
480
Qty Limit Days:
30
ID:
86022
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
312085
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86023
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
308429
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86024
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
283523
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
2160
Qty Limit Days:
30
ID:
86025
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
197745
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86026
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
197746
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86027
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
198358
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86028
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1099569
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86029
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1244214
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86030
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
197312
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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