Displaying 79011-79020 of 1611142 results.
ID:
79011
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
892582
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
79012
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
892672
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
79013
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1923822
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
79014
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1923828
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
79015
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1923826
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
79016
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1490026
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
79017
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1490034
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
79018
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1490038
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
79019
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
313580
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
79020
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
2257015
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
79011790127901379014790157901679017790187901979020