Displaying 216301-216310 of 1611142 results.
ID:
216301
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
311376
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
ID:
216302
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
864761
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
1200
Qty Limit Days:
30
ID:
216303
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
864769
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
600
Qty Limit Days:
30
ID:
216304
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
205301
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216305
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
315187
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216306
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
856724
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216307
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
856733
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216308
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
309371
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216309
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
197577
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216310
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
343033
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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