Displaying 216551-216560 of 1611142 results.
ID:
216551
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
199058
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216552
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
308868
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216553
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
403879
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
216554
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
476556
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
216555
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
197535
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216556
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
310295
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
216557
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
310297
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
216558
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
313992
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
216559
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
313993
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
216560
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
310293
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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