Displaying 58021-58030 of 1611142 results.
ID:
58021
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
724861
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
58022
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
403818
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58023
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
897021
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
58024
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2049264
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
91
Qty Limit Days:
84
ID:
58025
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1856424
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58026
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2052064
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58027
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
861375
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58028
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
861370
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58029
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1373745
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58030
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
485442
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
58021580225802358024580255802658027580285802958030