Displaying 63001-63010 of 1611142 results.
ID:
63001
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1540356
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63002
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
992475
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63003
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
995258
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63004
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1297753
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63005
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1297757
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63006
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049621
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
63007
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
2101899
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63008
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049683
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
63009
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049686
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
63010
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1091150
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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