Displaying 219031-219040 of 1611142 results.
ID:
219031
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
904396
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
219032
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
199672
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219033
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
252559
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
219034
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
239238
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219035
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
602393
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
219036
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
432402
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
219037
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
477560
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
219038
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
477562
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
219039
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1373497
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
180
ID:
219040
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
403875
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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