Displaying 77901-77910 of 1611142 results.
ID:
77901
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
2180336
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
77902
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
615979
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
77903
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
207059
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
15
Qty Limit Days:
30
ID:
77904
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
211140
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
77905
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
706831
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
77906
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
706827
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
77907
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
706829
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
77908
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
706825
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
77909
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
858074
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
0
Qty Limit Days:
28
ID:
77910
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
858051
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
0
Qty Limit Days:
28
77901779027790377904779057790677907779087790977910