Displaying 58761-58770 of 1611142 results.
ID:
58761
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
2103179
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
58762
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
810075
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58763
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
810079
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58764
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
2284108
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
21
Qty Limit Days:
28
ID:
58765
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
2057205
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58766
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
2057216
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58767
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
2057212
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58768
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
2057219
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58769
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
2099952
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
58770
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
2105860
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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