Displaying 74261-74270 of 1611142 results.
ID:
74261
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2390946
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
74262
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2058950
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
74263
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2058946
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
74264
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1722376
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
63
Qty Limit Days:
28
ID:
74265
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2100099
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
180
ID:
74266
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2100100
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
180
ID:
74267
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
312614
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
74268
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
283077
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
74269
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
993755
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
4500
Qty Limit Days:
30
ID:
74270
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
197448
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
74261742627426374264742657426674267742687426974270