Displaying 55501-55510 of 1611142 results.
ID:
55501
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1243010
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
55502
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1243014
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
55503
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1601394
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
21
Qty Limit Days:
28
ID:
55504
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1601386
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
21
Qty Limit Days:
28
ID:
55505
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1601390
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
21
Qty Limit Days:
28
ID:
55506
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1987734
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
55507
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2058922
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
55508
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2103175
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
55509
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2103179
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
55510
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
810075
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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