Displaying 205741-205750 of 1611142 results.
ID:
205741
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
1148502
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
205742
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
2168540
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
205743
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
207088
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
205744
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
855871
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
205745
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
1855527
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
180
ID:
205746
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
1921240
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
205747
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
1921245
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
180
ID:
205748
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
1726846
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
205749
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
847745
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
205750
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
1872980
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
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