Displaying 52201-52210 of 1611142 results.
ID:
52201
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
310793
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
52202
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
197624
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
52203
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1437968
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
52204
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1437969
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
52205
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
897657
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
1200
Qty Limit Days:
30
ID:
52206
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049604
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
1300
Qty Limit Days:
30
ID:
52207
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1874559
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
52208
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1874553
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
52209
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
900575
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
52210
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
977427
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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