Displaying 63621-63630 of 1611142 results.
ID:
63621
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
706829
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
63622
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
706825
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
63623
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
858074
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
0
Qty Limit Days:
28
ID:
63624
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
858051
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
0
Qty Limit Days:
28
ID:
63625
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
858057
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
0
Qty Limit Days:
28
ID:
63626
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
858055
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
ID:
63627
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
858053
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
ID:
63628
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
2059017
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
63629
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1232084
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
63630
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1232088
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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