Displaying 216401-216410 of 1611142 results.
ID:
216401
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
825170
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
6
Qty Limit Days:
180
ID:
216402
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1801278
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
180
ID:
216403
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
847741
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
216404
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
835892
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216405
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
212957
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216406
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
2056897
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216407
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
746609
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
112
Qty Limit Days:
28
ID:
216408
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
845512
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
216409
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
847734
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
24
Qty Limit Days:
30
ID:
216410
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1002300
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
112
Qty Limit Days:
28
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