Displaying 75051-75060 of 1611142 results.
ID:
75051
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
825335
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75052
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
825333
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75053
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
825325
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75054
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
825334
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75055
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1040025
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
35
Qty Limit Days:
28
ID:
75056
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
212118
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75057
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
542370
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75058
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1988768
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
75059
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1921228
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
75060
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1988772
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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