Displaying 78021-78030 of 1611142 results.
ID:
78021
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1313885
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78022
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
577237
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78023
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
310285
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78024
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
198359
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78025
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
389242
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78026
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
204119
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78027
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
2287905
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
30
ID:
78028
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
2056700
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
30
ID:
78029
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1358775
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78030
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
751884
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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