Displaying 203761-203770 of 1611142 results.
ID:
203761
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
1368006
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
203762
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
705129
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
203763
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
895487
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
203764
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
895987
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
203765
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
310982
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
203766
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
313189
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
203767
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
309290
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
203768
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
197362
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
203769
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
895990
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
203770
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
106336
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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