Displaying 57521-57530 of 1611142 results.
ID:
57521
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1600710
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57522
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1999587
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
57523
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1364515
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57524
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2373941
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57525
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2049677
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57526
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
762675
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57527
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
259966
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57528
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197973
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57529
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
401953
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
57530
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
401954
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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