Displaying 207011-207020 of 1611142 results.
ID:
207011
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
905100
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
207012
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
153822
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
207013
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
153823
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
207014
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
639537
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
207015
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
578325
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
207016
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
578330
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
207017
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
802749
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
207018
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
861822
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
207019
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
1095712
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
207020
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
1665515
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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