Displaying 54501-54510 of 1611142 results.
ID:
54501
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
686418
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54502
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
835829
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54503
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
860975
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
54504
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
860981
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
54505
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
312136
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54506
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
312137
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54507
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1299911
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54508
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
855861
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54509
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
197890
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54510
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
855873
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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