Displaying 58201-58210 of 1611142 results.
ID:
58201
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
314035
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58202
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197754
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58203
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
686924
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58204
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
200032
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58205
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
979092
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
58206
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1738483
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58207
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1738495
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58208
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1738503
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58209
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1099596
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58210
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197412
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
58201582025820358204582055820658207582085820958210