Displaying 215901-215910 of 1611142 results.
ID:
215901
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
904396
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
215902
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
199672
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
215903
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
252559
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
215904
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
239238
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
215905
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
602393
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
215906
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
432402
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
215907
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
477560
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
215908
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
477562
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
215909
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
861568
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
215910
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
692576
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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