Displaying 219461-219470 of 1611142 results.
ID:
219461
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
847745
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
300
Qty Limit Days:
30
ID:
219462
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1872980
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
219463
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1747577
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
219464
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1747579
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
219465
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1747567
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
219466
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1747580
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
42
Qty Limit Days:
30
ID:
219467
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1921017
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
219468
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1921010
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
219469
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1921468
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
180
ID:
219470
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
152971
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
480
Qty Limit Days:
30
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