Displaying 76201-76210 of 1611142 results.
ID:
76201
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1603361
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76202
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1603365
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76203
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1603369
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76204
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1656346
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76205
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1425110
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
76206
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1425118
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
76207
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
867506
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
76208
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1425230
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
76209
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1425228
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
76210
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1245003
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
76201762027620376204762057620676207762087620976210