Displaying 63571-63580 of 1611142 results.
ID:
63571
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1242815
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
56
ID:
63572
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
616749
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63573
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
728231
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63574
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1657212
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63575
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1735537
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63576
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
992403
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63577
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1735496
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63578
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1147228
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
63579
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
2197873
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
63580
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
2197877
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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