Displaying 75011-75020 of 1611142 results.
ID:
75011
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
886671
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75012
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
686400
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75013
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1190572
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75014
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
686418
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75015
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
476345
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
75016
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
476349
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
75017
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
476350
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
75018
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
476351
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
75019
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
835829
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75020
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
860975
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
75011750127501375014750157501675017750187501975020