Displaying 69021-69030 of 1611142 results.
ID:
69021
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
261101
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
69022
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
847232
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
28
ID:
69023
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
285018
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
40
Qty Limit Days:
28
ID:
69024
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
855178
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
69025
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
866094
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
69026
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
866083
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
69027
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
211817
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
69028
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
1801283
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
69029
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
857461
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
69030
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
978006
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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