Displaying 203801-203810 of 1611142 results.
ID:
203801
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
403878
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
203802
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
1098143
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
203803
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
2200174
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
203804
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
2200177
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
203805
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
2200180
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
203806
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
2200183
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
203807
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
1648755
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
28
Qty Limit Days:
14
ID:
203808
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
725021
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
1
ID:
203809
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
725023
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
1
ID:
203810
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
311994
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
14
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