Displaying 217711-217720 of 1611142 results.
ID:
217711
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1939299
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217712
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1939348
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217713
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
577324
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217714
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
727316
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
30
ID:
217715
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1870207
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
30
ID:
217716
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
2001430
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
217717
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
2003255
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217718
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
2043464
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217719
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1246321
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
217720
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
865208
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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