Displaying 52501-52510 of 1611142 results.
ID:
52501
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1490065
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
52502
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
199058
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
52503
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
596843
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
52504
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
308868
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
52505
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
403879
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
52506
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
476556
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
52507
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
197535
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
270
Qty Limit Days:
30
ID:
52508
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
310295
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
52509
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
310297
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
52510
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
313992
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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