Displaying 53501-53510 of 1611142 results.
ID:
53501
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
200094
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53502
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
200095
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53503
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
200096
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53504
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
197311
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53505
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
197313
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53506
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
313566
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53507
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
485434
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53508
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
485436
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53509
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
859424
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
53510
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
859747
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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