Displaying 57091-57100 of 1611142 results.
ID:
57091
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
312614
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57092
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
283077
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57093
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
993755
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
4500
Qty Limit Days:
30
ID:
57094
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197448
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57095
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1923432
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57096
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
477391
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57097
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197877
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
57098
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1010739
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57099
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
391937
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57100
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197305
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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