Displaying 222401-222410 of 1611142 results.
ID:
222401
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1874553
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
222402
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
900575
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
222403
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
977427
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
222404
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
977434
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
222405
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
977438
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
222406
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
892625
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
900
Qty Limit Days:
30
ID:
222407
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
311355
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222408
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
197893
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222409
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
313932
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222410
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
309843
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
1200
Qty Limit Days:
30
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