Displaying 77811-77820 of 1611142 results.
ID:
77811
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
349194
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
77812
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
349195
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
77813
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
349198
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
77814
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
403825
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
77815
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
312439
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77816
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
198103
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77817
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
250820
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
77818
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
858751
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77819
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
858733
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
77820
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
848943
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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