Displaying 216341-216350 of 1611142 results.
ID:
216341
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
2284108
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
21
Qty Limit Days:
28
ID:
216342
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
2057205
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216343
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
2057216
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216344
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
2057212
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216345
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
2057219
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216346
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
2099952
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
216347
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
2105860
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
216348
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
637188
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216349
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
795735
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216350
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
637190
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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