Displaying 53841-53850 of 1611142 results.
ID:
53841
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
993755
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
4500
Qty Limit Days:
30
ID:
53842
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
197448
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53843
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1923432
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53844
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
477391
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53845
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
197877
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
53846
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1010739
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53847
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
391937
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53848
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
197305
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53849
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
212787
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53850
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1312408
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
84
Qty Limit Days:
28
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