Displaying 215361-215370 of 1611142 results.
ID:
215361
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1926823
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
215362
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1926827
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
215363
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1812434
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
215364
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
866111
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
215365
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
198252
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
215366
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1373489
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
14
Qty Limit Days:
30
ID:
215367
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1373493
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
215368
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1373498
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
180
ID:
215369
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1649593
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
ID:
215370
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1546189
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
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