Displaying 57701-57710 of 1611142 results.
ID:
57701
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1939335
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
28
Qty Limit Days:
28
ID:
57702
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1999673
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57703
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
315183
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57704
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
831226
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57705
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
831255
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57706
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
831309
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57707
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
831338
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57708
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
831196
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57709
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
831248
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57710
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
831300
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
57701577025770357704577055770657707577085770957710