Displaying 222261-222270 of 1611142 results.
ID:
222261
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1731317
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222262
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
643177
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
222263
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
643173
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
222264
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
643175
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
222265
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
799830
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
222266
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1045408
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
222267
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1045404
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
222268
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1364441
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222269
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1364447
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222270
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
607579
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
630
Qty Limit Days:
30
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