Displaying 72721-72730 of 1611142 results.
ID:
72721
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1299917
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72722
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
995218
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72723
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1299896
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72724
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
866090
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72725
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
643066
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72726
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1652084
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72727
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1006801
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
72728
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
996921
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
72729
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
721773
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
72730
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
476179
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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