Displaying 205401-205410 of 1611142 results.
ID:
205401
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
903843
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
205402
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
1661799
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
205403
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
307732
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
205404
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
2049884
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
205405
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
1493276
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
205406
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
2055286
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
205407
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
2265701
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
205408
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
2283505
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
205409
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
2283515
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
28
ID:
205410
Formulary ID:
00021086
Formulary Version:
18
Contract Year:
2021
RXCUI:
2283518
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
28
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