Displaying 223411-223420 of 1611142 results.
ID:
223411
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1540356
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223412
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
992475
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223413
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
995258
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223414
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1297753
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223415
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1297757
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223416
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1049621
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
223417
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
2101899
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223418
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1049683
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
223419
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1049686
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
223420
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1091150
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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