Displaying 57021-57030 of 1611142 results.
ID:
57021
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
896758
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57022
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
896762
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57023
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
199369
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57024
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
645037
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
57025
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1000064
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57026
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197987
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57027
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197986
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57028
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
860215
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57029
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
860221
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57030
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
349194
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
57021570225702357024570255702657027570285702957030