Displaying 75401-75410 of 1611142 results.
ID:
75401
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1923822
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75402
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1923828
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75403
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1923826
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75404
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1490026
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
75405
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1490034
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
75406
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1490038
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
75407
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
313580
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75408
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2257015
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
75409
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2044720
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
75410
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2044726
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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