Displaying 53871-53880 of 1611142 results.
ID:
53871
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
858053
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
ID:
53872
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2059017
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53873
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1232084
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
53874
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1232088
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
53875
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1114202
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
53876
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1549683
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53877
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1650968
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
0
Qty Limit Days:
84
ID:
53878
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1650972
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
84
ID:
53879
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1650974
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
84
ID:
53880
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1650976
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
84
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