Displaying 204001-204010 of 1611142 results.
ID:
204001
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
1739774
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
204002
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
2173500
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
10
Qty Limit Days:
30
ID:
204003
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
1739778
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
204004
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
1739782
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
204005
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
1739770
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
204006
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
1251914
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
204007
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
722256
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
204008
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
1251918
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
204009
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
724142
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
204010
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
724156
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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