Displaying 54261-54270 of 1611142 results.
ID:
54261
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
794610
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54262
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
831870
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54263
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
850457
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54264
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1236632
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54265
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1359271
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54266
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
758555
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54267
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1052660
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54268
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1250723
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54269
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1600710
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54270
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1999587
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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