Displaying 57911-57920 of 1611142 results.
ID:
57911
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
198358
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57912
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1099569
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57913
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1244214
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57914
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197312
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
57915
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
485496
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
900
Qty Limit Days:
30
ID:
57916
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
348719
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57917
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2110774
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
8
Qty Limit Days:
28
ID:
57918
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2110777
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
8
Qty Limit Days:
28
ID:
57919
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2110780
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
8
Qty Limit Days:
28
ID:
57920
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2110783
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
8
Qty Limit Days:
28
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