Displaying 224911-224920 of 1611142 results.
ID:
224911
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1244064
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
224912
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
637216
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
224913
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
312941
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
224914
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
312938
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
224915
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
308194
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
224916
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
308182
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
224917
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
283406
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
224918
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
283407
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
224919
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
283485
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
224920
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
756209
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
1680
Qty Limit Days:
28
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