Displaying 53301-53310 of 1611142 results.
ID:
53301
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
197650
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53302
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
861601
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53303
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
861597
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53304
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
615882
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53305
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
284496
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53306
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
855926
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53307
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
855906
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
53308
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
855664
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
53309
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
995281
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53310
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1095227
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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