Displaying 5761-5770 of 1611142 results.
ID:
5761
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
1921228
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
5762
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
1988772
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
5763
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
1988786
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
5764
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
1723763
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
28
ID:
5765
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
1723767
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
28
ID:
5766
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
1723772
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
28
ID:
5767
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
1726639
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
5768
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
1364362
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
5769
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
1364358
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
5770
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
2473042
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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