Displaying 216701-216710 of 1611142 results.
ID:
216701
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
608934
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216702
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
832718
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216703
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1801299
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216704
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
832731
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216705
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1801295
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216706
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
2123111
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
13
Qty Limit Days:
30
ID:
216707
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
198071
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216708
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
197541
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
216709
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
753478
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216710
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
753479
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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