Displaying 208661-208670 of 1611142 results.
ID:
208661
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
2055014
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
208662
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
197701
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
208663
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
310433
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
208664
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
310434
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
208665
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
403966
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
208666
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
403967
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
208667
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
1358776
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
208668
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
309367
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
45
Qty Limit Days:
28
ID:
208669
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
198014
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
208670
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
311753
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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