Displaying 212701-212710 of 1611142 results.
ID:
212701
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1148506
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
212702
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1148502
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
212703
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
2168540
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
212704
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
207088
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
212705
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
855871
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
212706
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1855527
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
180
ID:
212707
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1921240
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
212708
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1921245
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
180
ID:
212709
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1726846
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
212710
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
847745
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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