Displaying 79221-79230 of 1611142 results.
ID:
79221
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1251336
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
79222
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
749157
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
79223
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
748798
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
79224
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1989507
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
79225
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1053697
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
79226
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
197849
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
79227
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1876920
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
79228
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1876924
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
79229
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1876916
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
79230
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
1111642
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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