Displaying 216151-216160 of 1611142 results.
ID:
216151
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1731317
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216152
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
643177
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
216153
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
643173
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
216154
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
643175
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
216155
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
799830
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
216156
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1045408
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
216157
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1045404
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
216158
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1364441
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216159
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1364447
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216160
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
607579
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
630
Qty Limit Days:
30
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