Displaying 221621-221630 of 1611142 results.
ID:
221621
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1812434
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
221622
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
866111
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
221623
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
198252
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
221624
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1373489
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
14
Qty Limit Days:
30
ID:
221625
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1373493
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
221626
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1373498
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
180
ID:
221627
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
1040058
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
221628
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
858804
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
221629
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
902624
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
221630
Formulary ID:
00021096
Formulary Version:
14
Contract Year:
2021
RXCUI:
902626
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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