Displaying 79411-79420 of 1611142 results.
ID:
79411
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
2272126
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
79412
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
2394947
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
79413
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
2199304
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
79414
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
2199308
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
79415
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
2199312
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
79416
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
2199316
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
79417
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
206883
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
79418
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
2473107
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
79419
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
206902
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
79420
Formulary ID:
00021028
Formulary Version:
14
Contract Year:
2021
RXCUI:
483450
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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