Displaying 57721-57730 of 1611142 results.
ID:
57721
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
897596
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57722
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
317769
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57723
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
314208
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57724
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
312847
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57725
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
205284
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57726
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
205285
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57727
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
643019
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
57728
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
643022
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
57729
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
866482
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57730
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
866479
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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