Displaying 53201-53210 of 1611142 results.
ID:
53201
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
584414
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53202
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
857297
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53203
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
857301
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53204
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
857305
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53205
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1596780
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
300
Qty Limit Days:
30
ID:
53206
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
855292
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53207
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
855306
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53208
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
855316
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53209
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
855322
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53210
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
855328
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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