Displaying 204071-204080 of 1611142 results.
ID:
204071
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
848176
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
204072
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
848178
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
204073
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
861505
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
204074
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
1191310
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
204075
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
313200
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
204076
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
103456
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
204077
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
310891
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
204078
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
308979
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
204079
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
197686
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
204080
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
197303
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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