Displaying 54131-54140 of 1611142 results.
ID:
54131
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
310353
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54132
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
200257
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
54133
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
200256
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
54134
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
200258
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
54135
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
313582
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54136
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
313584
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54137
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
314277
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54138
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
313586
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54139
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
311759
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54140
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
866511
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
54131541325413354134541355413654137541385413954140