Displaying 225311-225320 of 1611142 results.
ID:
225311
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1602040
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
225312
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
1602046
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
2
Qty Limit Days:
28
ID:
225313
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
2265729
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
225314
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
2265732
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
225315
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
2265735
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
225316
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
199888
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
225317
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
151226
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
225318
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
199889
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
225319
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
311486
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
225320
Formulary ID:
00021097
Formulary Version:
13
Contract Year:
2021
RXCUI:
904396
NDC:
Tier Level:
1
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
28
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