Displaying 214831-214840 of 1611142 results.
ID:
214831
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
205329
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
214832
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
205330
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
214833
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
205331
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
214834
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
999967
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
214835
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
999996
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
214836
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
999986
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
214837
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1000001
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
214838
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
999991
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
214839
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
984082
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
214840
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1551923
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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