Displaying 54021-54030 of 1611142 results.
ID:
54021
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1191302
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54022
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
310152
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
54023
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2180999
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54024
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1716268
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54025
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1921598
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54026
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
828348
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54027
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1369831
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
540
Qty Limit Days:
30
ID:
54028
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1870950
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
54029
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1870956
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
54030
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1870952
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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