Displaying 217921-217930 of 1611142 results.
ID:
217921
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1370750
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217922
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
203088
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
28
ID:
217923
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
313227
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217924
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
313226
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217925
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
848208
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217926
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
848176
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217927
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
848178
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217928
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1191310
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217929
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
313200
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
217930
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
310891
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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