Displaying 58101-58110 of 1611142 results.
ID:
58101
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
205304
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58102
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
205305
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58103
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
409823
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58104
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
892582
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
58105
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
892672
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
58106
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1923822
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58107
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1923828
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58108
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1923826
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58109
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1490026
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
58110
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1490034
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
58101581025810358104581055810658107581085810958110