Displaying 63401-63410 of 1611142 results.
ID:
63401
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
795749
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63402
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1809520
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63403
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
239189
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63404
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1665107
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63405
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
309072
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63406
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
863538
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63407
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1665507
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63408
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
240209
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63409
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
318202
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
63410
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
238600
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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