Displaying 216721-216730 of 1611142 results.
ID:
216721
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1189640
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216722
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
800933
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216723
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
207273
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
216724
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
2001321
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
216725
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1091843
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
216726
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
402091
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
216727
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1986819
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
216728
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1942485
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
216729
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1942489
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
216730
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1721571
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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