Displaying 58291-58300 of 1611142 results.
ID:
58291
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1876920
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
58292
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1876924
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
58293
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1876916
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
58294
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1111642
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
58295
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1487363
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
28
ID:
58296
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
308725
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
420
Qty Limit Days:
30
ID:
58297
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
855657
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
58298
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1812011
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58299
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1812013
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58300
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
562806
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
100
Qty Limit Days:
30
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