Displaying 76621-76630 of 1611142 results.
ID:
76621
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
801000
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76622
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
801021
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76623
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
801031
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76624
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
866924
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76625
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
197465
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
76626
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
197466
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
76627
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
856720
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76628
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
197505
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76629
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
198286
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
76630
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1298857
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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