Displaying 59211-59220 of 1611142 results.
ID:
59211
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1799890
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
59212
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
800928
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
59213
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
800812
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
59214
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1189640
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
59215
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
800933
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
59216
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
2001321
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
28
Qty Limit Days:
28
ID:
59217
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1091843
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
59218
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
402091
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
59219
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
1986819
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
59220
Formulary ID:
00021021
Formulary Version:
14
Contract Year:
2021
RXCUI:
2289424
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
300
Qty Limit Days:
30
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