Displaying 58471-58480 of 1611142 results.
ID:
58471
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
483450
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
58472
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
483438
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
58473
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
483440
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
58474
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
483444
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
58475
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2178403
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
12
Qty Limit Days:
28
ID:
58476
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2178405
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
16
Qty Limit Days:
28
ID:
58477
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2382990
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
24
Qty Limit Days:
28
ID:
58478
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2178407
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
32
Qty Limit Days:
28
ID:
58479
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2178409
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
20
Qty Limit Days:
28
ID:
58480
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2382991
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
16
Qty Limit Days:
28
58471584725847358474584755847658477584785847958480