Displaying 54111-54120 of 1611142 results.
ID:
54111
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1648162
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54112
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1648160
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54113
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2048718
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
54114
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2048722
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
54115
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1991509
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54116
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1865962
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54117
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
197699
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54118
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
197700
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54119
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
596926
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
54120
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
596930
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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