Displaying 57411-57420 of 1611142 results.
ID:
57411
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2118741
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57412
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2000019
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
28
Qty Limit Days:
28
ID:
57413
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1994362
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
28
Qty Limit Days:
28
ID:
57414
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1442992
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
57415
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2000023
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
28
Qty Limit Days:
28
ID:
57416
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2000027
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
28
Qty Limit Days:
28
ID:
57417
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2000031
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
28
Qty Limit Days:
28
ID:
57418
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1300386
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57419
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
829989
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57420
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
830552
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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