Displaying 58011-58020 of 1611142 results.
ID:
58011
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
722126
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58012
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
722131
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58013
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
860715
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
58014
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
860695
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
58015
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
860707
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
58016
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1800499
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58017
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1800500
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58018
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
992150
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58019
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
724863
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
58020
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
724859
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
58011580125801358014580155801658017580185801958020