Displaying 53611-53620 of 1611142 results.
ID:
53611
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
312079
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
53612
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
208185
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53613
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
577127
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
53614
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
403908
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53615
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
198038
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53616
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
198039
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53617
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
198040
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53618
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1010600
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
53619
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1307056
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
53620
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1010604
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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