Displaying 219671-219680 of 1611142 results.
ID:
219671
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
859835
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219672
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1099687
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219673
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
312036
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219674
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
856940
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
5550
Qty Limit Days:
30
ID:
219675
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
834137
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219676
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
810002
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
219677
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
809990
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
219678
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
809994
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
219679
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
809998
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
219680
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
995156
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
1200
Qty Limit Days:
30
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