Displaying 58821-58830 of 1611142 results.
ID:
58821
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1873087
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58822
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1940709
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
84
Qty Limit Days:
28
ID:
58823
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1597388
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58824
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
835896
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58825
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
835835
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58826
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1115468
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58827
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1926069
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58828
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1115259
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58829
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1115459
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
58830
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1115464
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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