Displaying 72711-72720 of 1611142 results.
ID:
72711
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
904876
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
72712
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1314763
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72713
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
309047
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72714
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
312594
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72715
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
198141
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72716
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
834046
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72717
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
834040
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72718
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
197536
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
72719
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
429212
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
72720
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
309374
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
135
Qty Limit Days:
30
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