Displaying 75321-75330 of 1611142 results.
ID:
75321
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
861375
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75322
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
861370
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75323
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1373745
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75324
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
485442
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
75325
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
485465
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
75326
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
352066
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
75327
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
656660
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
75328
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1989085
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
112
Qty Limit Days:
28
ID:
75329
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1442143
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
75330
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1729053
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
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