Displaying 218501-218510 of 1611142 results.
ID:
218501
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1099678
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
218502
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1099870
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
218503
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1356563
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
218504
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1356572
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
218505
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1356576
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
218506
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1356580
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
218507
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1356584
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
218508
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1356588
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
218509
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1790126
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
720
Qty Limit Days:
30
ID:
218510
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
824299
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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