Displaying 166621-166630 of 1611142 results.
ID:
166621
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
892352
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
166622
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
894814
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
166623
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
892554
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
90
Qty Limit Days:
30
ID:
166624
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
991039
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
166625
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
991194
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
166626
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
991336
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
166627
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
991044
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
166628
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
991188
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
166629
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
584414
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
166630
Formulary ID:
00021067
Formulary Version:
13
Contract Year:
2021
RXCUI:
857297
NDC:
Tier Level:
4
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
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