Displaying 54211-54220 of 1611142 results.
ID:
54211
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1544398
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54212
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1544402
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54213
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1659818
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
ID:
54214
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1659814
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
ID:
54215
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1658325
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
54216
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1658329
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
54217
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1658333
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
54218
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1658337
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
54219
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1658341
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
54220
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1658345
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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