Displaying 87041-87050 of 1611142 results.
ID:
87041
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
1425110
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
87042
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
1425118
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
87043
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
867506
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
87044
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
1425230
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
87045
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
1425228
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
87046
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
1245003
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
87047
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
825425
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
87048
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
825429
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
87049
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
884619
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
87050
Formulary ID:
00021031
Formulary Version:
14
Contract Year:
2021
RXCUI:
2121061
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
84
Qty Limit Days:
28
87041870428704387044870458704687047870488704987050