Displaying 57921-57930 of 1611142 results.
ID:
57921
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2110786
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
8
Qty Limit Days:
28
ID:
57922
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2183131
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
57923
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
866907
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57924
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2000133
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
57925
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1801519
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
57926
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
539789
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
9
Qty Limit Days:
30
ID:
57927
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
856666
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
57928
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
979115
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
16
Qty Limit Days:
28
ID:
57929
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1244062
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
16
Qty Limit Days:
28
ID:
57930
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1244064
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
11
Qty Limit Days:
28
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