Displaying 218701-218710 of 1611142 results.
ID:
218701
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
857174
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
218702
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
904431
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
218703
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
312087
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
218704
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
198334
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
218705
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
198335
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
218706
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
979468
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
218707
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
979464
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
218708
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
979471
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
218709
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
198188
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
218710
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
313134
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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