Displaying 78501-78510 of 1611142 results.
ID:
78501
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049227
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
78502
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049216
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
78503
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
854801
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78504
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
313477
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78505
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
861200
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78506
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
861208
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78507
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1000647
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78508
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1000862
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78509
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1000897
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78510
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1923428
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
78501785027850378504785057850678507785087850978510