Displaying 222351-222360 of 1611142 results.
ID:
222351
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1595457
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222352
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
402092
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
222353
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
861637
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222354
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
861206
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222355
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
904170
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222356
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1604544
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222357
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
2002420
NDC:
Tier Level:
6
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222358
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1876406
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
8
Qty Limit Days:
28
ID:
222359
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
2375329
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
8
Qty Limit Days:
28
ID:
222360
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
2099302
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
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