Displaying 74501-74510 of 1611142 results.
ID:
74501
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1811182
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
74502
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1649405
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
74503
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
852920
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
74504
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
313096
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
74505
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
198224
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
74506
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
318179
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
74507
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
283535
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
74508
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
858778
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
74509
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
198222
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
74510
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
198150
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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