Displaying 53141-53150 of 1611142 results.
ID:
53141
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1085728
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53142
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1191315
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53143
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
628953
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53144
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
381056
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53145
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
206842
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53146
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
198316
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53147
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
359296
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53148
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
308212
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53149
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
403810
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
53150
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
403811
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
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