Displaying 217601-217610 of 1611142 results.
ID:
217601
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
312079
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
217602
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
208185
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217603
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
577127
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
217604
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
403908
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217605
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
198038
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217606
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
198039
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217607
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
198040
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217608
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
248642
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217609
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1010600
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
217610
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1307056
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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