Displaying 57041-57050 of 1611142 results.
ID:
57041
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1486687
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57042
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197797
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57043
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197726
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57044
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
860225
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57045
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1430383
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57046
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1440185
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57047
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2107008
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57048
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1550536
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57049
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2104192
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57050
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1994764
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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