Displaying 58311-58320 of 1611142 results.
ID:
58311
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
830801
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58312
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
352257
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
540
Qty Limit Days:
30
ID:
58313
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2393794
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
540
Qty Limit Days:
30
ID:
58314
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2121764
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
58315
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2173841
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
58316
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1364477
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58317
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1602028
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
58318
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1602034
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
58319
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1602040
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
58320
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1602046
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
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