Displaying 225701-225710 of 1611142 results.
ID:
225701
Formulary ID:
00021098
Formulary Version:
10
Contract Year:
2021
RXCUI:
197931
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
225702
Formulary ID:
00021098
Formulary Version:
10
Contract Year:
2021
RXCUI:
312617
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
225703
Formulary ID:
00021098
Formulary Version:
10
Contract Year:
2021
RXCUI:
198144
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
225704
Formulary ID:
00021098
Formulary Version:
10
Contract Year:
2021
RXCUI:
198146
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
225705
Formulary ID:
00021098
Formulary Version:
10
Contract Year:
2021
RXCUI:
207850
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
17
Qty Limit Days:
30
ID:
225706
Formulary ID:
00021098
Formulary Version:
10
Contract Year:
2021
RXCUI:
207100
NDC:
Tier Level:
3
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
225707
Formulary ID:
00021098
Formulary Version:
10
Contract Year:
2021
RXCUI:
1307630
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
225708
Formulary ID:
00021098
Formulary Version:
10
Contract Year:
2021
RXCUI:
1307635
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
30
Qty Limit Days:
30
ID:
225709
Formulary ID:
00021098
Formulary Version:
10
Contract Year:
2021
RXCUI:
1243010
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
180
Qty Limit Days:
30
ID:
225710
Formulary ID:
00021098
Formulary Version:
10
Contract Year:
2021
RXCUI:
1243014
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
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