Displaying 58111-58120 of 1611142 results.
ID:
58111
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1490038
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
58112
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
313580
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58113
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2257015
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
58114
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2044720
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
58115
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2044726
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
58116
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2044732
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
58117
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2046376
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58118
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2046380
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58119
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2046370
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58120
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
311288
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
58111581125811358114581155811658117581185811958120