Displaying 53531-53540 of 1611142 results.
ID:
53531
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1665515
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53532
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1719286
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53533
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
313115
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53534
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
239240
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53535
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
809871
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
20
Qty Limit Days:
30
ID:
53536
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
864661
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53537
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2001424
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53538
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1363408
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
112
Qty Limit Days:
28
ID:
53539
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1363410
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
112
Qty Limit Days:
28
ID:
53540
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1364581
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
112
Qty Limit Days:
28
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