Displaying 52801-52810 of 1611142 results.
ID:
52801
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
198325
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
52802
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
198323
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
52803
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
855942
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
52804
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
313366
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
52805
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1000070
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
52806
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1536586
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
28
ID:
52807
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
242333
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
52808
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
241527
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
52809
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
403922
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
52810
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
402109
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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