Displaying 211701-211710 of 1611142 results.
ID:
211701
Formulary ID:
00021091
Formulary Version:
13
Contract Year:
2021
RXCUI:
1040058
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
211702
Formulary ID:
00021091
Formulary Version:
13
Contract Year:
2021
RXCUI:
858804
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
211703
Formulary ID:
00021091
Formulary Version:
13
Contract Year:
2021
RXCUI:
1790892
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
211704
Formulary ID:
00021091
Formulary Version:
13
Contract Year:
2021
RXCUI:
1790886
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
211705
Formulary ID:
00021091
Formulary Version:
13
Contract Year:
2021
RXCUI:
1790890
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
211706
Formulary ID:
00021091
Formulary Version:
13
Contract Year:
2021
RXCUI:
2384465
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
5
Qty Limit Days:
28
ID:
211707
Formulary ID:
00021091
Formulary Version:
13
Contract Year:
2021
RXCUI:
1670324
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
211708
Formulary ID:
00021091
Formulary Version:
13
Contract Year:
2021
RXCUI:
1670322
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
211709
Formulary ID:
00021091
Formulary Version:
13
Contract Year:
2021
RXCUI:
1737789
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
211710
Formulary ID:
00021091
Formulary Version:
13
Contract Year:
2021
RXCUI:
309952
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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