Displaying 72921-72930 of 1611142 results.
ID:
72921
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2055008
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72922
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
991233
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72923
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1098608
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
72924
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
308047
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
72925
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
308048
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
72926
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
197321
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
72927
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
197322
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
72928
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
198057
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
72929
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
312134
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
72930
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
198059
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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