Displaying 219451-219460 of 1611142 results.
ID:
219451
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
2168548
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219452
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
2058932
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
219453
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1148506
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
219454
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1148502
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
219455
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
207088
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219456
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
855871
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219457
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1855527
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
180
ID:
219458
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1921240
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
219459
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1921245
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
180
ID:
219460
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1726846
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
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