Displaying 213001-213010 of 1611142 results.
ID:
213001
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
897126
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
9
Qty Limit Days:
30
ID:
213002
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
2398842
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
28
ID:
213003
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1991311
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
ID:
213004
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1991317
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
28
ID:
213005
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
2200654
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
213006
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
2200658
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
213007
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
2200650
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
213008
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1653204
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
213009
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
351926
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
213010
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
197590
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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