Displaying 57121-57130 of 1611142 results.
ID:
57121
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
858057
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
0
Qty Limit Days:
28
ID:
57122
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
858055
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
ID:
57123
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
858053
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
ID:
57124
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2059017
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
57125
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1232084
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
57126
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1232088
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
57127
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1114202
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
57128
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1549683
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57129
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1650968
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
0
Qty Limit Days:
84
ID:
57130
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1650972
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
84
57121571225712357124571255712657127571285712957130