Displaying 77021-77030 of 1611142 results.
ID:
77021
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1862701
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
77022
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1862697
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
77023
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1862692
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
77024
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1037181
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
77025
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1037049
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
77026
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
991082
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77027
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
702519
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77028
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
314182
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77029
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
885219
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77030
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
885213
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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