Displaying 72011-72020 of 1611142 results.
ID:
72011
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
1812013
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72012
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
562806
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
100
Qty Limit Days:
30
ID:
72013
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
825130
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72014
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
260260
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72015
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
1370758
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
72016
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
311382
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72017
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
861668
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
8
Qty Limit Days:
28
ID:
72018
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
830795
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72019
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
831359
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72020
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
801957
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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