Displaying 86451-86460 of 1611142 results.
ID:
86451
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1876920
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
86452
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1876924
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
86453
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1876916
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
86454
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1111642
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
86455
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1487363
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
28
ID:
86456
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
308725
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
420
Qty Limit Days:
30
ID:
86457
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
855657
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
86458
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1812011
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86459
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
1812013
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86460
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
562806
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
100
Qty Limit Days:
30
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