Displaying 219501-219510 of 1611142 results.
ID:
219501
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1364122
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219502
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1603361
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
6
Qty Limit Days:
21
ID:
219503
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1603365
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
6
Qty Limit Days:
21
ID:
219504
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1603369
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
6
Qty Limit Days:
21
ID:
219505
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1656346
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
219506
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1425110
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
219507
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1425118
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
219508
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
867506
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
219509
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
672152
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
219510
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1425230
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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