Displaying 212751-212760 of 1611142 results.
ID:
212751
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1364122
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
212752
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1603361
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
6
Qty Limit Days:
21
ID:
212753
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1603365
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
6
Qty Limit Days:
21
ID:
212754
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1603369
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
6
Qty Limit Days:
21
ID:
212755
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1656346
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
212756
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1425110
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
212757
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1425118
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
212758
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
867506
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
212759
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
672152
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
212760
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1425230
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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