Displaying 57401-57410 of 1611142 results.
ID:
57401
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1654079
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57402
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
853354
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57403
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
853356
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57404
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
848164
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57405
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1653144
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57406
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1482814
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57407
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1653166
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57408
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1100079
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
57409
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1918044
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
57410
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1928689
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
57401574025740357404574055740657407574085740957410