Displaying 53151-53160 of 1611142 results.
ID:
53151
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1806195
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
53152
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1806179
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53153
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1806183
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
53154
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
308191
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53155
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
199119
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53156
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
864110
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53157
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
854302
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53158
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1793916
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
53159
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1657160
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
53160
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1654630
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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