Displaying 55121-55130 of 1611142 results.
ID:
55121
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1798375
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
55122
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
200132
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
55123
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
199149
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
55124
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
199150
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
55125
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
311915
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55126
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1725064
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
30
ID:
55127
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2001439
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
55128
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1437713
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55129
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1918242
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
55130
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1862595
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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