Displaying 77251-77260 of 1611142 results.
ID:
77251
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
615882
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77252
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
284496
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77253
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
197848
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77254
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
855926
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
77255
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
855906
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
77256
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
855664
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
77257
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
995281
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77258
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1095227
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77259
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1304988
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77260
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1661092
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
91
Qty Limit Days:
84
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