Displaying 213901-213910 of 1611142 results.
ID:
213901
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
897683
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
213902
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
314184
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
213903
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
311918
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
18
Qty Limit Days:
28
ID:
213904
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
314135
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
18
Qty Limit Days:
28
ID:
213905
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
897722
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
213906
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
197942
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
213907
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
197941
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
213908
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
861007
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
213909
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
861010
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
213910
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
861004
NDC:
Tier Level:
6
Qty Limit?:
0
Qty Limit Amt:
75
Qty Limit Days:
30
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