Displaying 216021-216030 of 1611142 results.
ID:
216021
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
2045961
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216022
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
2045958
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216023
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
2059189
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216024
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
2055286
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216025
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
2265701
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
216026
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
2283505
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
216027
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
2283515
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
28
ID:
216028
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
2283518
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
56
Qty Limit Days:
28
ID:
216029
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
2283509
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
216030
Formulary ID:
00021094
Formulary Version:
13
Contract Year:
2021
RXCUI:
2283513
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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