Displaying 55211-55220 of 1611142 results.
ID:
55211
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2394947
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
55212
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2199304
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55213
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2199308
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55214
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2199312
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55215
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2199316
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55216
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
206883
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55217
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
2473107
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55218
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
206902
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55219
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
483450
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
55220
Formulary ID:
00021018
Formulary Version:
14
Contract Year:
2021
RXCUI:
483438
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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