Displaying 58811-58820 of 1611142 results.
ID:
58811
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1747577
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
58812
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1747579
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
58813
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1747567
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
58814
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1747580
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58815
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1921017
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58816
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1921010
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58817
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1921468
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58818
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
152971
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58819
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
2166143
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58820
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
2196900
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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