Displaying 86941-86950 of 1611142 results.
ID:
86941
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
2103179
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
86942
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
810075
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86943
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
810079
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86944
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
2284108
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
21
Qty Limit Days:
28
ID:
86945
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
2057205
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86946
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
2057216
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86947
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
2057212
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86948
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
2057219
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
86949
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
2099952
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
86950
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
2105860
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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