Displaying 55731-55740 of 1611142 results.
ID:
55731
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1006801
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
55732
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
996921
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
55733
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
721773
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
55734
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
476179
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
55735
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
476177
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
55736
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
199703
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55737
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1359129
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55738
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
485440
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
55739
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1860157
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
55740
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1860129
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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