Displaying 51401-51410 of 1611142 results.
ID:
51401
Formulary ID:
00021017
Formulary Version:
14
Contract Year:
2021
RXCUI:
283536
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
51402
Formulary ID:
00021017
Formulary Version:
14
Contract Year:
2021
RXCUI:
199387
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
480
Qty Limit Days:
30
ID:
51403
Formulary ID:
00021017
Formulary Version:
14
Contract Year:
2021
RXCUI:
308429
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
51404
Formulary ID:
00021017
Formulary Version:
14
Contract Year:
2021
RXCUI:
283523
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
2160
Qty Limit Days:
30
ID:
51405
Formulary ID:
00021017
Formulary Version:
14
Contract Year:
2021
RXCUI:
197745
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
51406
Formulary ID:
00021017
Formulary Version:
14
Contract Year:
2021
RXCUI:
197746
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
51407
Formulary ID:
00021017
Formulary Version:
14
Contract Year:
2021
RXCUI:
198358
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
51408
Formulary ID:
00021017
Formulary Version:
14
Contract Year:
2021
RXCUI:
1099569
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
51409
Formulary ID:
00021017
Formulary Version:
14
Contract Year:
2021
RXCUI:
1244214
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
51410
Formulary ID:
00021017
Formulary Version:
14
Contract Year:
2021
RXCUI:
197312
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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