Displaying 222491-222500 of 1611142 results.
ID:
222491
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
847745
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
300
Qty Limit Days:
30
ID:
222492
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1872980
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
ID:
222493
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1747577
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
222494
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1747579
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
222495
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1747567
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
222496
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1747580
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
42
Qty Limit Days:
30
ID:
222497
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1921017
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
222498
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1921010
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
222499
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1921468
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
3
Qty Limit Days:
180
ID:
222500
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
152971
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
480
Qty Limit Days:
30
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