Displaying 55201-55210 of 1611142 results.
ID:
55201
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1999314
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55202
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
1999316
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55203
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2058520
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
28
ID:
55204
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2058525
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
28
ID:
55205
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
208083
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55206
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2054275
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
14
Qty Limit Days:
28
ID:
55207
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2275613
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
55208
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2272118
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
55209
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2272122
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
55210
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2272126
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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