Displaying 215701-215710 of 1611142 results.
ID:
215701
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
853201
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
215702
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1649990
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
215703
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
1650030
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
215704
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
198201
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
215705
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
728109
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
215706
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
312122
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
215707
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
200346
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
215708
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
308135
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
215709
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
309054
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
215710
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
826612
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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