Displaying 206801-206810 of 1611142 results.
ID:
206801
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
1607784
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
206802
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
199245
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
206803
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
199246
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
206804
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
199247
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
206805
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
314231
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
206806
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
312961
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
206807
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
198211
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
206808
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
200060
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
206809
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
317573
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
206810
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
312440
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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