Displaying 209201-209210 of 1611142 results.
ID:
209201
Formulary ID:
00021091
Formulary Version:
13
Contract Year:
2021
RXCUI:
1921240
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
209202
Formulary ID:
00021091
Formulary Version:
13
Contract Year:
2021
RXCUI:
1921245
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
180
ID:
209203
Formulary ID:
00021091
Formulary Version:
13
Contract Year:
2021
RXCUI:
1726846
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
209204
Formulary ID:
00021091
Formulary Version:
13
Contract Year:
2021
RXCUI:
847745
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
209205
Formulary ID:
00021091
Formulary Version:
13
Contract Year:
2021
RXCUI:
1872980
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
209206
Formulary ID:
00021091
Formulary Version:
13
Contract Year:
2021
RXCUI:
1747577
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
209207
Formulary ID:
00021091
Formulary Version:
13
Contract Year:
2021
RXCUI:
1747579
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
209208
Formulary ID:
00021091
Formulary Version:
13
Contract Year:
2021
RXCUI:
1747567
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
209209
Formulary ID:
00021091
Formulary Version:
13
Contract Year:
2021
RXCUI:
1747580
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
42
Qty Limit Days:
30
ID:
209210
Formulary ID:
00021091
Formulary Version:
13
Contract Year:
2021
RXCUI:
1921017
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
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