Displaying 208811-208820 of 1611142 results.
ID:
208811
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
866910
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
208812
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
308867
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
208813
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
198037
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
208814
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
1092357
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
208815
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
1665473
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
208816
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
1798370
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
208817
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
1798375
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
208818
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
200132
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
208819
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
199149
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
208820
Formulary ID:
00021087
Formulary Version:
13
Contract Year:
2021
RXCUI:
199150
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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