Displaying 96171-96180 of 1611142 results.
ID:
96171
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1870968
NDC:
Tier Level:
5
Qty Limit?:
0
Qty Limit Amt:
91
Qty Limit Days:
28
ID:
96172
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1304985
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
120
Qty Limit Days:
30
ID:
96173
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1811182
NDC:
Tier Level:
3
Qty Limit?:
0
Qty Limit Amt:
240
Qty Limit Days:
30
ID:
96174
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
1649405
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
96175
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
852920
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
96176
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
313096
NDC:
Tier Level:
1
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
96177
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
198224
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
96178
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
318179
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
96179
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
283535
NDC:
Tier Level:
2
Qty Limit?:
1
Qty Limit Amt:
0
Qty Limit Days:
0
ID:
96180
Formulary ID:
00021037
Formulary Version:
14
Contract Year:
2021
RXCUI:
858778
NDC:
Tier Level:
2
Qty Limit?:
0
Qty Limit Amt:
150
Qty Limit Days:
30
96171961729617396174961759617696177961789617996180