Displaying 53051-53060 of 1611142 results.
ID:
53051
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
897618
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53052
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
897624
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53053
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
897630
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53054
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
312025
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53055
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
198041
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53056
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
582926
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53057
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1597123
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
300
Qty Limit Days:
30
ID:
53058
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1597129
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
300
Qty Limit Days:
30
ID:
53059
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
238134
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
53060
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1745091
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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