Displaying 86491-86500 of 1611142 results.
ID:
86491
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
199888
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86492
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
151226
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86493
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
199889
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86494
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
311486
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86495
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
904396
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
86496
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
199672
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86497
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
252559
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86498
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
239238
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86499
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
602393
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86500
Formulary ID:
00021030
Formulary Version:
14
Contract Year:
2021
RXCUI:
432402
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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