Displaying 77621-77630 of 1611142 results.
ID:
77621
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1010604
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
77622
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
198182
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77623
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
351223
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
6
Qty Limit Days:
28
ID:
77624
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
198070
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77625
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
401938
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
77626
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
751566
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77627
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
751568
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77628
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
751570
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77629
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
897044
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77630
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
758032
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
6
Qty Limit Days:
28
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