Displaying 57311-57320 of 1611142 results.
ID:
57311
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1373337
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57312
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
312084
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57313
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
198051
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57314
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
312077
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
57315
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
313412
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57316
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
313413
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57317
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
314286
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
57318
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
313776
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
57319
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
313777
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
57320
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
313778
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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