Displaying 75021-75030 of 1611142 results.
ID:
75021
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
860981
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
75022
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
312136
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75023
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
312137
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75024
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1299911
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75025
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
855861
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75026
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
197890
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75027
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
855873
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75028
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2360548
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75029
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
308989
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75030
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
308988
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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