Displaying 205301-205310 of 1611142 results.
ID:
205301
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
904396
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
205302
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
199672
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
205303
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
252559
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
205304
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
239238
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
205305
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
602393
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
205306
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
432402
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
205307
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
485423
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
205308
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
485421
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
205309
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
477560
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
205310
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
477562
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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