Displaying 166151-166160 of 1611142 results.
ID:
166151
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
312128
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
166152
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
240637
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
166153
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
800420
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
166154
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
800405
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
166155
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
801405
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
166156
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
800438
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
166157
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
800444
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
166158
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
866924
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
166159
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
197465
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
166160
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
197466
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
360
Qty Limit Days:
30
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