Displaying 217091-217100 of 1611142 results.
ID:
217091
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
603378
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
217092
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1190225
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
8
Qty Limit Days:
30
ID:
217093
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
836368
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
25
Qty Limit Days:
30
ID:
217094
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1430453
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
217095
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1430457
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
217096
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1100706
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
217097
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1430449
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
217098
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1592748
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
217099
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1592752
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
217100
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1243033
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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