Displaying 54801-54810 of 1611142 results.
ID:
54801
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2123076
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
36
Qty Limit Days:
30
ID:
54802
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
349591
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
54803
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
349592
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
54804
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
349593
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
54805
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1011736
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54806
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1011739
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54807
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
388311
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54808
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
200133
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54809
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
200131
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
54810
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
861237
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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