Displaying 55401-55410 of 1611142 results.
ID:
55401
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1595457
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55402
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2268231
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
16
Qty Limit Days:
30
ID:
55403
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2268227
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
16
Qty Limit Days:
30
ID:
55404
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
402092
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
55405
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
861637
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55406
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
861206
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55407
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
904170
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55408
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
854859
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55409
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1859000
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
55410
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1604544
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
13
Qty Limit Days:
28
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