Displaying 216321-216330 of 1611142 results.
ID:
216321
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
197931
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216322
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
312617
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216323
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
198144
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216324
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
198146
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216325
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
213272
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216326
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
207100
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216327
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
804547
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216328
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1307630
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
216329
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1307635
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
216330
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1243010
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
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