Displaying 58531-58540 of 1611142 results.
ID:
58531
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
2178792
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
30
ID:
58532
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
644304
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58533
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
861659
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58534
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
861661
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58535
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
861663
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58536
Formulary ID:
00021020
Formulary Version:
14
Contract Year:
2021
RXCUI:
545278
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58537
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1551300
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
58538
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1551306
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
58539
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
2058877
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
30
ID:
58540
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1745108
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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