Displaying 212721-212730 of 1611142 results.
ID:
212721
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
2196900
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
212722
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1873087
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
180
ID:
212723
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1541594
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
212724
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
835896
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
212725
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
835835
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
212726
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1115468
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
212727
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1926069
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
212728
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1115259
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
212729
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1115459
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
212730
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1115464
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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