Displaying 223401-223410 of 1611142 results.
ID:
223401
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
672569
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
223402
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
672571
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
223403
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
993541
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
223404
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
993557
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
223405
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
996615
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223406
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
996594
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223407
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
996603
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223408
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
996609
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223409
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
966920
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223410
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
801054
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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