Displaying 75721-75730 of 1611142 results.
ID:
75721
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
849515
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75722
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
833008
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75723
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
883826
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
75724
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
197943
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75725
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
197944
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75726
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1659929
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75727
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2102705
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75728
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2058906
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
75729
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
1872458
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
75730
Formulary ID:
00021026
Formulary Version:
14
Contract Year:
2021
RXCUI:
2049133
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
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