Displaying 53251-53260 of 1611142 results.
ID:
53251
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2101899
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53252
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049683
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
53253
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049686
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
53254
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1091150
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
53255
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
899557
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53256
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
899518
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53257
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
899548
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53258
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1091133
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
900
Qty Limit Days:
30
ID:
53259
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
863664
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53260
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1006122
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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