Displaying 219801-219810 of 1611142 results.
ID:
219801
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1795252
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219802
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
244098
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219803
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
245220
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219804
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1189640
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219805
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
800933
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219806
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
207273
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
219807
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
2001321
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
219808
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1091843
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
219809
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
402091
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
219810
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1986819
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
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