Displaying 52301-52310 of 1611142 results.
ID:
52301
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1855527
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
52302
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1921240
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
52303
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1921245
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
52304
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1726846
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
52305
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
847745
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
300
Qty Limit Days:
30
ID:
52306
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1872980
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
52307
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1747577
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
52308
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1747579
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
52309
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1747567
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
52310
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1747580
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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