Displaying 75701-75710 of 1611142 results.
ID:
75701
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
308867
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75702
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1092357
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75703
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1665473
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
75704
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1798370
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
75705
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1798375
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
75706
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
200132
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
75707
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
199149
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
75708
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
199150
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
75709
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
311915
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75710
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1725064
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
30
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