Displaying 58701-58710 of 1611142 results.
ID:
58701
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
894780
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
300
Qty Limit Days:
30
ID:
58702
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
997287
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
58703
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
997296
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
58704
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
310792
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58705
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
310793
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58706
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
197624
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58707
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1437968
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58708
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1437969
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58709
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
897657
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
1200
Qty Limit Days:
30
ID:
58710
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1049604
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
1300
Qty Limit Days:
30
58701587025870358704587055870658707587085870958710