Displaying 87021-87030 of 1611142 results.
ID:
87021
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
845518
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
28
Qty Limit Days:
28
ID:
87022
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
845512
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
28
ID:
87023
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
847734
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
87024
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
860244
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
15
Qty Limit Days:
30
ID:
87025
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
1002300
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
112
Qty Limit Days:
28
ID:
87026
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
998191
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
28
Qty Limit Days:
28
ID:
87027
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
1012899
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
87028
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
1119402
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
28
Qty Limit Days:
28
ID:
87029
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
1310138
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
112
Qty Limit Days:
28
ID:
87030
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
1310144
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
112
Qty Limit Days:
28
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