Displaying 76381-76390 of 1611142 results.
ID:
76381
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
197737
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76382
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
310534
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76383
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1362706
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76384
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1362712
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76385
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1362720
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76386
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
308865
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
76387
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
828379
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76388
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1860154
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
76389
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1860151
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
76390
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1860127
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
76381763827638376384763857638676387763887638976390