Displaying 57801-57810 of 1611142 results.
ID:
57801
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1364358
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
57802
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2473042
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
57803
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2049271
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
57804
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2049278
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
57805
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197518
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57806
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
284215
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57807
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
544840
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57808
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
313165
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
57809
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
865129
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57810
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1807513
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
57801578025780357804578055780657807578085780957810