Displaying 75131-75140 of 1611142 results.
ID:
75131
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
858804
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75132
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
794641
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
75133
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
902624
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
75134
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
902626
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
75135
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
617768
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
75136
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1790892
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
75137
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1790886
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
75138
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1790890
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
75139
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2384465
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
5
Qty Limit Days:
28
ID:
75140
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1670324
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
80
Qty Limit Days:
28
75131751327513375134751357513675137751387513975140