Displaying 76411-76420 of 1611142 results.
ID:
76411
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1099687
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76412
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
312036
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76413
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
856940
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
2700
Qty Limit Days:
30
ID:
76414
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
834137
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76415
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
810002
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
76416
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
809990
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
76417
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
809994
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
76418
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
809998
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
76419
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
995156
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
1200
Qty Limit Days:
30
ID:
76420
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
308963
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
76411764127641376414764157641676417764187641976420