Displaying 78761-78770 of 1611142 results.
ID:
78761
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
309952
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78762
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
197622
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78763
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
309955
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78764
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1117531
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
50
Qty Limit Days:
30
ID:
78765
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1116758
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
25
Qty Limit Days:
30
ID:
78766
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
543492
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78767
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1440936
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78768
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
309077
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78769
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
313428
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78770
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
242680
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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