Displaying 57441-57450 of 1611142 results.
ID:
57441
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1310531
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
57442
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1310535
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
57443
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1547231
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57444
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2110618
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
57445
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1114074
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
57446
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1114096
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
57447
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
903841
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57448
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1114470
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
57449
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049504
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
57450
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049545
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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