Displaying 58221-58230 of 1611142 results.
ID:
58221
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
312817
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58222
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
577315
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58223
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
577317
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58224
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
836395
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
300
Qty Limit Days:
30
ID:
58225
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
833234
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58226
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
905158
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58227
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
199376
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58228
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
199381
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58229
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
898490
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58230
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
686429
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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