Displaying 57621-57630 of 1611142 results.
ID:
57621
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
351107
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
57622
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
859193
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57623
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
686379
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
57624
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
855818
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
57625
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
855812
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
57626
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1665050
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57627
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1665093
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57628
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1665088
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57629
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1665046
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57630
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1091650
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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