Displaying 222701-222710 of 1611142 results.
ID:
222701
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
351133
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
222702
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
313979
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222703
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
834127
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222704
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
141935
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222705
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
849385
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222706
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
861848
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222707
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
859835
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222708
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1099687
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222709
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
312036
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
222710
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
856940
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
5550
Qty Limit Days:
30
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