Displaying 78811-78820 of 1611142 results.
ID:
78811
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
2110780
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
8
Qty Limit Days:
28
ID:
78812
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
2110783
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
8
Qty Limit Days:
28
ID:
78813
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
2110786
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
8
Qty Limit Days:
28
ID:
78814
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
2183131
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
78815
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
866907
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78816
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
2000133
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
78817
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1873765
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
78818
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1801519
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
78819
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
539789
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
9
Qty Limit Days:
30
ID:
78820
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
856666
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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