Displaying 59201-59210 of 1611142 results.
ID:
59201
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
753479
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
59202
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1428933
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
59203
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1091828
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
59204
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
351173
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
59205
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
351174
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
59206
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
351175
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
59207
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
794639
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
59208
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
616578
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
59209
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
801417
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
59210
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
204520
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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