Displaying 57131-57140 of 1611142 results.
ID:
57131
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1650974
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
84
ID:
57132
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1650976
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
84
ID:
57133
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1739766
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
57134
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1739774
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
57135
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2173500
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
10
Qty Limit Days:
30
ID:
57136
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1739778
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
57137
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1739782
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
57138
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
795085
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57139
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
849599
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57140
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1739770
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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