Displaying 76091-76100 of 1611142 results.
ID:
76091
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
198146
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76092
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
213272
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76093
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
207100
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76094
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
804547
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76095
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1307630
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
76096
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1307635
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
76097
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1243010
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
76098
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1243014
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
76099
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1601394
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
21
Qty Limit Days:
28
ID:
76100
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1601386
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
21
Qty Limit Days:
28
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