Displaying 55921-55930 of 1611142 results.
ID:
55921
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
308048
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
55922
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197321
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
55923
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197322
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
55924
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
198033
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55925
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197444
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55926
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197445
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55927
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197816
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55928
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197815
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55929
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1001004
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
55930
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
351264
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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