Displaying 57351-57360 of 1611142 results.
ID:
57351
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1605455
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57352
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1649946
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57353
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1649964
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57354
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
993456
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
180
ID:
57355
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1046402
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57356
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1649491
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57357
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1649495
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57358
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2168596
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57359
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2045638
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
30
ID:
57360
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2120195
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
30
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