Displaying 57251-57260 of 1611142 results.
ID:
57251
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
403884
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57252
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
310599
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57253
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
856535
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57254
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
856569
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57255
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
856460
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57256
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
856481
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57257
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
860654
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57258
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
199450
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
57259
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
246172
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
57260
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1606337
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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