Displaying 53771-53780 of 1611142 results.
ID:
53771
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
199369
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53772
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
645037
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53773
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1000064
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53774
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
197987
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53775
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
197986
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53776
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
860215
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53777
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
860221
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53778
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
349194
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
53779
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
349195
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
53780
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
349198
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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