Displaying 75611-75620 of 1611142 results.
ID:
75611
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
748798
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75612
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1989507
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75613
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1053697
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75614
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
197849
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75615
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1876920
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
75616
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1876924
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
75617
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1876916
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
75618
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1111642
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
75619
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1487363
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
28
ID:
75620
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
308725
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
420
Qty Limit Days:
30
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