Displaying 217721-217730 of 1611142 results.
ID:
217721
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
865212
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
217722
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
865216
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
217723
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
723827
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
1575
Qty Limit Days:
28
ID:
217724
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
729201
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
217725
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
729203
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
217726
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1796079
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
217727
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1796083
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
217728
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1433879
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
217729
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1546894
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
217730
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1857913
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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