Displaying 53431-53440 of 1611142 results.
ID:
53431
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1116150
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53432
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
310594
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53433
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
905379
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53434
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1790533
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53435
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1791560
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53436
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1791569
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53437
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1791576
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
53438
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1791582
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
53439
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1812015
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53440
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
862006
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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