Displaying 225001-225010 of 1611142 results.
ID:
225001
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1800500
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
225002
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
992150
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
225003
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
403818
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
225004
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
897021
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
225005
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
2049264
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
225006
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1856424
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
225007
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
2052064
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
225008
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
861375
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
225009
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
861370
NDC:
Tier Level:
5
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
225010
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1373745
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
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