Displaying 55021-55030 of 1611142 results.
ID:
55021
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1245919
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55022
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1242786
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55023
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
200329
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55024
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
864681
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55025
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
307731
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55026
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
864675
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55027
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
835726
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55028
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
349373
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55029
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
857216
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55030
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
857224
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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