Displaying 58091-58100 of 1611142 results.
ID:
58091
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
312840
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
30
ID:
58092
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
314209
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
30
ID:
58093
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
199206
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
58094
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197805
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58095
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197806
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58096
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197807
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58097
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
311347
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58098
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
311204
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58099
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
898715
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
900
Qty Limit Days:
30
ID:
58100
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
282755
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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