Displaying 72631-72640 of 1611142 results.
ID:
72631
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1251596
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72632
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
207035
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72633
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
261101
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72634
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
847232
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
28
ID:
72635
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
285018
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
40
Qty Limit Days:
28
ID:
72636
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
855178
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72637
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
866094
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72638
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
866083
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72639
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
211817
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72640
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1801283
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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