Displaying 53321-53330 of 1611142 results.
ID:
53321
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1605086
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53322
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
904419
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
53323
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
866436
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53324
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
855633
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53325
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1607784
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53326
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
199245
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
53327
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
199246
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
53328
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
199247
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53329
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
314231
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
53330
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
312961
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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