Displaying 53561-53570 of 1611142 results.
ID:
53561
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1298816
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
53562
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1298906
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
270
Qty Limit Days:
30
ID:
53563
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
858613
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53564
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
858616
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53565
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
858747
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53566
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
891881
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
53567
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
891888
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
53568
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
891893
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53569
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
891874
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53570
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
892646
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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