Displaying 217611-217620 of 1611142 results.
ID:
217611
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1010604
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
217612
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
198182
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217613
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
351223
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
6
Qty Limit Days:
30
ID:
217614
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
198070
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217615
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
2477272
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
217616
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1809520
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217617
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
239189
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217618
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1665107
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217619
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
309072
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217620
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
863538
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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