Displaying 53931-53940 of 1611142 results.
ID:
53931
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
203088
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
53932
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
313227
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53933
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
857366
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
170
Qty Limit Days:
30
ID:
53934
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
313226
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53935
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
848208
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53936
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
848176
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53937
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
848178
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53938
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
313200
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53939
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
103456
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
53940
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
310891
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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