Displaying 75301-75310 of 1611142 results.
ID:
75301
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
722137
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75302
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
722126
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75303
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
722131
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75304
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
860715
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
75305
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
860695
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
75306
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
860707
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
75307
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
309058
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75308
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
419849
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75309
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1800499
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75310
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1800500
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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