Displaying 219201-219210 of 1611142 results.
ID:
219201
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
905057
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219202
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
751970
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219203
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
836358
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219204
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1191250
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219205
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
207373
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219206
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1245268
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
219207
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
885209
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219208
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1922765
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219209
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
1922763
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219210
Formulary ID:
00021095
Formulary Version:
13
Contract Year:
2021
RXCUI:
105553
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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