Displaying 219161-219170 of 1611142 results.
ID:
219161
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
2199316
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219162
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
483450
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
219163
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
483438
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
219164
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
483440
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
219165
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
483444
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
219166
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
2178403
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219167
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
2178405
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219168
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
2382990
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219169
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
2178407
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219170
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
2178409
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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