Displaying 53921-53930 of 1611142 results.
ID:
53921
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1812470
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
53922
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1655934
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
53923
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2053512
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
28
ID:
53924
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
904158
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53925
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
861495
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53926
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
197407
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53927
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
310364
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53928
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
238920
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53929
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
861487
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53930
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1992281
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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