Displaying 207401-207410 of 1611142 results.
ID:
207401
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
313786
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
207402
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
212787
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
207403
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
1312408
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
84
Qty Limit Days:
28
ID:
207404
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
1439894
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
207405
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
1439896
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
207406
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
1439899
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
207407
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
1439901
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
207408
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
1439903
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
207409
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
2105657
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
207410
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
2105645
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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