Displaying 63771-63780 of 1611142 results.
ID:
63771
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
2465556
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63772
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
905394
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63773
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
404539
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63774
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1543069
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
63775
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1010878
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63776
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1085741
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63777
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1191302
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63778
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
310152
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
63779
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
2180999
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
63780
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1716268
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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