Displaying 58381-58390 of 1611142 results.
ID:
58381
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1918242
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
58382
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1862595
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
58383
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1921589
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
58384
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1862590
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
58385
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1666542
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58386
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
831246
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58387
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
849515
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58388
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
833008
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58389
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
883826
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
58390
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
197943
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
58381583825838358384583855838658387583885838958390