Displaying 223021-223030 of 1611142 results.
ID:
223021
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1437702
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223022
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
211343
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223023
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
857002
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
223024
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
857005
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
223025
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
856999
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
223026
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
2001565
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223027
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
2001566
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223028
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
2001568
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223029
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
993781
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
223030
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1049221
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
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