Displaying 72491-72500 of 1611142 results.
ID:
72491
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2058922
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
72492
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2103175
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
72493
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2103179
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
72494
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
810075
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72495
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
810079
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72496
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2284108
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
21
Qty Limit Days:
28
ID:
72497
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2057205
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72498
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2057216
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72499
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2057212
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72500
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2057219
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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