Displaying 57271-57280 of 1611142 results.
ID:
57271
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1010878
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57272
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1085741
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57273
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1191302
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57274
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
310152
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
57275
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2180999
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57276
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1716268
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57277
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1921598
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57278
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
828348
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57279
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1369831
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
540
Qty Limit Days:
30
ID:
57280
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1870950
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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