Displaying 54301-54310 of 1611142 results.
ID:
54301
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
855194
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54302
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1607617
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
54303
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
311345
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54304
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
198200
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54305
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
351256
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54306
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
351257
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54307
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
310261
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54308
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
308459
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54309
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
141963
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54310
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1000126
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
84
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