Displaying 57111-57120 of 1611142 results.
ID:
57111
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2180336
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
57112
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
615979
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
57113
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
207059
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
15
Qty Limit Days:
30
ID:
57114
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
211140
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
57115
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
706831
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
57116
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
706827
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
57117
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
706829
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
57118
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
706825
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
57119
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
858074
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
0
Qty Limit Days:
28
ID:
57120
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
858051
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
0
Qty Limit Days:
28
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