Displaying 53711-53720 of 1611142 results.
ID:
53711
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
725023
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
53712
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
311994
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
53713
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
311995
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
53714
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1648759
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
53715
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1307061
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53716
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1115698
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
540
Qty Limit Days:
180
ID:
53717
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1308569
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
53718
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
351209
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53719
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
197623
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53720
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2055650
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
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