Displaying 58041-58050 of 1611142 results.
ID:
58041
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1729029
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
58042
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1729033
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
58043
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1729047
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
58044
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1729076
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58045
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2261800
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
58046
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1799001
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58047
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1790317
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58048
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
727714
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58049
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
314230
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58050
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
861646
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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