Displaying 58211-58220 of 1611142 results.
ID:
58211
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
312828
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
58212
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
312829
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
58213
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
312830
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
58214
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
312831
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
58215
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
312832
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
58216
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
314211
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
58217
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
199890
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58218
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
845488
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58219
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
861736
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
58220
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
861740
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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