Displaying 65021-65030 of 1611142 results.
ID:
65021
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1245268
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
112
Qty Limit Days:
28
ID:
65022
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
314088
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
65023
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
403914
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
65024
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
885209
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
65025
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1922765
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
65026
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1922763
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
65027
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
105553
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
65028
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
105590
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
65029
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1364498
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
45
Qty Limit Days:
30
ID:
65030
Formulary ID:
00021022
Formulary Version:
14
Contract Year:
2021
RXCUI:
1364490
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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