Displaying 86771-86780 of 1611142 results.
ID:
86771
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
665036
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
86772
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
1547114
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
86773
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
1547118
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
86774
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
1235595
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86775
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
1235591
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86776
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
668606
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86777
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
861821
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
86778
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
861771
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
86779
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
1729311
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
6
Qty Limit Days:
28
ID:
86780
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
2055766
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
86771867728677386774867758677686777867788677986780