Displaying 223211-223220 of 1611142 results.
ID:
223211
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
314075
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223212
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
310812
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223213
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
861427
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223214
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
991086
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223215
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
314006
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
223216
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
315107
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
223217
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
310489
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
223218
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
250344
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
28
ID:
223219
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
722122
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
223220
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
722116
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
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