Displaying 222481-222490 of 1611142 results.
ID:
222481
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
2168548
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222482
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
2058932
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
222483
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1148506
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
222484
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1148502
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
222485
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
207088
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222486
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
855871
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222487
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1855527
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
180
ID:
222488
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1921240
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
222489
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1921245
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
180
ID:
222490
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1726846
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
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