Displaying 55771-55780 of 1611142 results.
ID:
55771
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1299909
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55772
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197737
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55773
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
310534
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55774
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1362706
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55775
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1362712
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55776
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1362720
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55777
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
308865
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
55778
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1860154
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
55779
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1860151
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
55780
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1860127
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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