Displaying 53391-53400 of 1611142 results.
ID:
53391
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
861007
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
53392
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
861010
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
53393
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
861004
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
75
Qty Limit Days:
30
ID:
53394
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
861731
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
53395
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
562524
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53396
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1652673
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53397
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1650142
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53398
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
353538
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53399
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
897666
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53400
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1099288
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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