Displaying 53031-53040 of 1611142 results.
ID:
53031
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
310149
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
4
ID:
53032
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1000673
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53033
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
284254
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53034
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
197900
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
53035
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
197901
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
53036
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
197902
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
53037
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
311386
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53038
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
311385
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53039
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
314075
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53040
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
310812
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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