Displaying 53471-53480 of 1611142 results.
ID:
53471
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
884185
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53472
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
884189
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53473
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1099625
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53474
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
996571
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53475
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
996561
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53476
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
854916
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53477
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
854919
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53478
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
854908
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53479
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
201708
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53480
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
248420
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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