Displaying 216281-216290 of 1611142 results.
ID:
216281
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
310793
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
216282
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
197624
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216283
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1437968
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216284
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1437969
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216285
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
897657
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
2400
Qty Limit Days:
30
ID:
216286
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1874559
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
216287
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1874553
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
216288
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
900575
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
216289
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
977427
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
216290
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
977434
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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