Displaying 72481-72490 of 1611142 results.
ID:
72481
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
207100
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72482
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
804547
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72483
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1307630
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
72484
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1307635
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
72485
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1243010
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
72486
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1243014
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
72487
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1601394
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
21
Qty Limit Days:
28
ID:
72488
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1601386
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
21
Qty Limit Days:
28
ID:
72489
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1601390
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
21
Qty Limit Days:
28
ID:
72490
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1987734
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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