Displaying 223801-223810 of 1611142 results.
ID:
223801
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
198040
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223802
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
198430
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223803
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
252478
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223804
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
103968
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223805
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
252479
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223806
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1010600
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
ID:
223807
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1307056
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
223808
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1010604
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
223809
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
198182
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
223810
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
351223
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
6
Qty Limit Days:
30
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