Displaying 53241-53250 of 1611142 results.
ID:
53241
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
996615
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
53242
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
996594
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
53243
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
996603
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
53244
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
996609
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
53245
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1540356
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53246
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
992475
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53247
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
995258
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53248
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1297753
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53249
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1297757
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53250
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049621
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
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