Displaying 69621-69630 of 1611142 results.
ID:
69621
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
1000913
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
69622
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
198202
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
69623
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
857677
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
69624
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
1245443
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
69625
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
1245373
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
69626
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
309329
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
69627
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
314078
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
69628
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
197635
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
69629
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
197634
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
69630
Formulary ID:
00021025
Formulary Version:
14
Contract Year:
2021
RXCUI:
238154
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
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