Displaying 53831-53840 of 1611142 results.
ID:
53831
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1242998
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
53832
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2106075
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53833
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2390946
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53834
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2058950
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53835
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2058946
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53836
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1722376
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
63
Qty Limit Days:
28
ID:
53837
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2100099
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
180
ID:
53838
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2100100
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
180
ID:
53839
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
312614
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53840
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
283077
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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