Displaying 217301-217310 of 1611142 results.
ID:
217301
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1091210
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217302
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
861601
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217303
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
861597
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
1
Qty Limit Days:
28
ID:
217304
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
615882
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217305
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
643070
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
217306
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
284496
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217307
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
855926
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217308
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
855906
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217309
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
855664
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217310
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
995281
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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