Displaying 75231-75240 of 1611142 results.
ID:
75231
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
861753
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75232
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
309076
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75233
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
309078
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75234
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
198352
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75235
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
200031
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75236
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
200033
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75237
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
315223
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
18
Qty Limit Days:
30
ID:
75238
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
313161
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
18
Qty Limit Days:
30
ID:
75239
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
313160
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
9
Qty Limit Days:
30
ID:
75240
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
854873
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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