Displaying 55131-55140 of 1611142 results.
ID:
55131
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1921589
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
55132
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1862590
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
55133
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1666542
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55134
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
831246
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55135
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
849515
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55136
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
833008
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55137
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
883826
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
55138
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
197943
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55139
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
197944
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55140
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1659929
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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