Displaying 74301-74310 of 1611142 results.
ID:
74301
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
858053
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
ID:
74302
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2059017
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
74303
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1232084
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
74304
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1232088
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
74305
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1114202
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
74306
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1549683
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
74307
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1650968
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
0
Qty Limit Days:
84
ID:
74308
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1650972
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
84
ID:
74309
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1650974
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
84
ID:
74310
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1650976
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
84
74301743027430374304743057430674307743087430974310