Displaying 5371-5380 of 1611142 results.
ID:
5371
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
853356
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
5372
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
848164
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
5373
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
1653144
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
5374
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
1482814
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
5375
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
1653166
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
5376
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
1100079
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
5377
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
1918044
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
5378
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
1928689
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
5379
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
2118741
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
5380
Formulary ID:
00021001
Formulary Version:
14
Contract Year:
2021
RXCUI:
2000019
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
28
Qty Limit Days:
28
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