Displaying 57241-57250 of 1611142 results.
ID:
57241
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1806185
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
57242
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2468058
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57243
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2471314
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57244
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
748962
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57245
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
831533
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57246
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
312138
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57247
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
312839
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
30
ID:
57248
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
312837
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
30
ID:
57249
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1091341
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
900
Qty Limit Days:
30
ID:
57250
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1359124
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
57241572425724357244572455724657247572485724957250