Displaying 231211-231220 of 1611142 results.
ID:
231211
Formulary ID:
00021099
Formulary Version:
10
Contract Year:
2021
RXCUI:
2100100
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
4
Qty Limit Days:
180
ID:
231212
Formulary ID:
00021099
Formulary Version:
10
Contract Year:
2021
RXCUI:
312614
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
231213
Formulary ID:
00021099
Formulary Version:
10
Contract Year:
2021
RXCUI:
283077
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
231214
Formulary ID:
00021099
Formulary Version:
10
Contract Year:
2021
RXCUI:
993755
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
4500
Qty Limit Days:
30
ID:
231215
Formulary ID:
00021099
Formulary Version:
10
Contract Year:
2021
RXCUI:
197448
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
231216
Formulary ID:
00021099
Formulary Version:
10
Contract Year:
2021
RXCUI:
1923432
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
231217
Formulary ID:
00021099
Formulary Version:
10
Contract Year:
2021
RXCUI:
578018
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
231218
Formulary ID:
00021099
Formulary Version:
10
Contract Year:
2021
RXCUI:
477391
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
231219
Formulary ID:
00021099
Formulary Version:
10
Contract Year:
2021
RXCUI:
197877
NDC:
Tier Level:
4
Qty Limit?:
0
Qty Limit Amt:
60
Qty Limit Days:
30
ID:
231220
Formulary ID:
00021099
Formulary Version:
10
Contract Year:
2021
RXCUI:
1010739
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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