Displaying 53371-53380 of 1611142 results.
ID:
53371
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1190655
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53372
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
545236
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53373
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1724340
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53374
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
312075
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53375
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
308345
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53376
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
197636
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53377
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
260243
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53378
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
312641
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53379
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1312625
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53380
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1365660
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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