Displaying 77401-77410 of 1611142 results.
ID:
77401
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1791569
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
77402
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1791576
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
77403
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1791582
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
77404
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1812015
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77405
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
862006
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77406
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
862013
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77407
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
862019
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77408
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
862025
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77409
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1665102
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77410
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1737578
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
77401774027740377404774057740677407774087740977410