Displaying 58451-58460 of 1611142 results.
ID:
58451
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2283540
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58452
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
311944
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58453
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1999314
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58454
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1999316
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58455
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2058520
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
28
ID:
58456
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2058525
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
28
ID:
58457
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
208083
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58458
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2054275
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
14
Qty Limit Days:
28
ID:
58459
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2275613
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
58460
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2272118
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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