Displaying 57611-57620 of 1611142 results.
ID:
57611
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
617312
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57612
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
617310
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57613
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
617311
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57614
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
310818
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57615
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
259255
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57616
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
905028
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
ID:
57617
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
905024
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
57618
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
577208
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
57619
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
205328
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57620
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
314155
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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