Displaying 208761-208770 of 1611142 results.
ID:
208761
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
904396
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
208762
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
199672
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
208763
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
252559
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
208764
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
239238
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
208765
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
602393
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
208766
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
432402
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
208767
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
477560
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
208768
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
477562
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
208769
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
1373497
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
180
ID:
208770
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
403875
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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