Displaying 58521-58530 of 1611142 results.
ID:
58521
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1922765
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58522
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1922763
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58523
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
105553
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58524
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
105590
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58525
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1364498
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
45
Qty Limit Days:
30
ID:
58526
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1364490
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
58527
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1364494
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
58528
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1648772
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
58529
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2046597
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
228
Qty Limit Days:
14
ID:
58530
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
1989117
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
30
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