Displaying 53701-53710 of 1611142 results.
ID:
53701
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1659927
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53702
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2046585
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
53703
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
403878
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
53704
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1098143
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53705
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2200174
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53706
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2200177
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53707
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2200180
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
53708
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2200183
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53709
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1648755
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53710
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
725021
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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