Displaying 72501-72510 of 1611142 results.
ID:
72501
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2099952
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
72502
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2105860
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
72503
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2469340
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72504
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
637188
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
336
Qty Limit Days:
365
ID:
72505
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
795735
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
336
Qty Limit Days:
365
ID:
72506
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
637190
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
336
Qty Limit Days:
365
ID:
72507
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
795737
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72508
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2284104
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
21
Qty Limit Days:
28
ID:
72509
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1741049
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72510
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2273115
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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