Displaying 77201-77210 of 1611142 results.
ID:
77201
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
977939
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
77202
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
977942
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
77203
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
197593
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77204
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
199168
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77205
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
312357
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77206
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
312362
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77207
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
2106334
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77208
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1661220
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77209
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1809580
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77210
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
854876
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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