Displaying 217621-217630 of 1611142 results.
ID:
217621
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1665507
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217622
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1608276
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
217623
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1608274
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217624
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1191299
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217625
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
240209
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217626
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1797883
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
217627
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
318202
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217628
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
238600
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217629
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
310465
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217630
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1085640
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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