Displaying 77071-77080 of 1611142 results.
ID:
77071
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
308191
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77072
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
199119
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77073
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
864110
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77074
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
854302
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77075
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1793916
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
77076
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1657160
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
77077
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1654630
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
77078
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
2000007
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
28
ID:
77079
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
309339
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77080
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
309335
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
77071770727707377074770757707677077770787707977080