Displaying 58501-58510 of 1611142 results.
ID:
58501
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2467571
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
58502
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2467575
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
58503
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2472789
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58504
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2478450
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
58505
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2369403
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
58506
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1594673
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58507
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
905059
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
ID:
58508
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
905064
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
84
ID:
58509
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
905057
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
168
ID:
58510
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1251334
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
58501585025850358504585055850658507585085850958510