Displaying 4101 - 4120 of 4247
  • Print
Contract Number Brand Code Brand Name Active Ingredient Trade Name Package Size Formulary Category Pkg Price Unit Price Unit Description Max. Reimbursable Quantity / Month Package Description Manufacturer Code Manufacturer Name Agent Code Agent Name Benefit Therapeutic Code Therapeutic Desc Drug Contract Start Date Drug Contract End Date Status Description Default Route Max Repeats Therapeutic Head Amend Date
40 B1523 XARELTO 15MG TAB (BSP/AHI) RIVAROXABAN RIVAROXABAN XARELTO 28'S C 169.92 6.07 TABLET 0 TAB BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 20120412 DIRECT THROMBIN INHIBITORS 2022-04-01 2024-03-31 Oral 0 BLOOD FORMATION, COAGULATION AND THROMBOSIS
41 B1523 XARELTO 15MG TAB (BSP) RIVAROXABAN (C) RIVAROXABAN XARELTO 28'S C 169.92 6.0687 TAB 30 BOX BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 20120412 DIRECT THROMBIN INHIBITORS 2024-04-01 2026-03-31 ORAL 0 DIRECT THROMBIN INHIBITORS
40 B1524 PRADAX 110MG TAB (BOE/STO) DABIGATRAN DABIGATRAN PRADAX 60'S BQ 177.51 2.96 TABLET 0 TAB BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD 20120412 DIRECT THROMBIN INHIBITORS 2022-04-01 2024-03-31 Oral 6 BLOOD FORMATION, COAGULATION AND THROMBOSIS
41 B1524 PRADAX 110MG TAB (BOE) DABIGATRAN (BQ) DABIGATRAN PRADAX 60'S BQ 193.27 3.2212 TAB 60 BOX BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD 20120412 DIRECT THROMBIN INHIBITORS 2024-04-01 2026-03-31 ORAL 6 DIRECT THROMBIN INHIBITORS
40 B1525 XARELTO 15MG TAB (BSP/COL) RIVAROXABAN RIVAROXABAN XARELTO 28'S C 169.92 6.07 TABLET 0 TAB BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 20120412 DIRECT THROMBIN INHIBITORS 2022-04-01 2024-03-31 Oral 0 BLOOD FORMATION, COAGULATION AND THROMBOSIS
41 B1525 XARELTO 15MG TAB (BSP) RIVAROXABAN (C) RIVAROXABAN XARELTO 28'S C 169.92 6.0687 TAB 30 BOX BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 20120412 DIRECT THROMBIN INHIBITORS 2024-04-01 2026-03-31 ORAL 0 DIRECT THROMBIN INHIBITORS
40 B1526 ELIQUIS 5MG TAB (PFI/STO) APIXABAN APIXABAN ELIQUIS 60'S C 219.40 3.66 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 20120412 DIRECT THROMBIN INHIBITORS 2022-04-01 2024-03-31 Oral 0 BLOOD FORMATION, COAGULATION AND THROMBOSIS
41 B1526 ELIQUIS 5MG TAB (PFI) APIXABAN (B) APIXABAN ELIQUIS 60'S B 175.33 2.9222 TAB 60 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 20120412 DIRECT THROMBIN INHIBITORS 2024-04-01 2026-03-31 ORAL 6 DIRECT THROMBIN INHIBITORS
40 B1527 XARELTO 15MG TAB (BSP/AHI) RIVAROXABAN RIVAROXABAN XARELTO 14'S C 84.97 6.07 TABLET 0 TAB BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 20120412 DIRECT THROMBIN INHIBITORS 2022-04-01 2024-03-31 Oral 0 BLOOD FORMATION, COAGULATION AND THROMBOSIS
41 B1527 XARELTO 15MG TAB (BSP) RIVAROXABAN (C) RIVAROXABAN XARELTO 14'S C 84.97 6.0696 TAB 30 BOX BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 20120412 DIRECT THROMBIN INHIBITORS 2024-04-01 2026-03-31 ORAL 0 DIRECT THROMBIN INHIBITORS
40 B1528 XARELTO 15MG TAB (BSP/COL) RIVAROXABAN RIVAROXABAN XARELTO 14'S C 84.97 6.07 TABLET 0 TAB BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 20120412 DIRECT THROMBIN INHIBITORS 2022-04-01 2024-03-31 Oral 0 BLOOD FORMATION, COAGULATION AND THROMBOSIS
41 B1528 XARELTO 15MG TAB (BSP) RIVAROXABAN (C) RIVAROXABAN XARELTO 14'S C 84.97 6.0696 TAB 30 BOX BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 20120412 DIRECT THROMBIN INHIBITORS 2024-04-01 2026-03-31 ORAL 0 DIRECT THROMBIN INHIBITORS
40 B1531 PRADAX 150MG TAB (BOE/STO) DABIGATRAN DABIGATRAN PRADAX 60'S BQ 177.51 2.96 TABLET 0 TAB BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD 20120412 DIRECT THROMBIN INHIBITORS 2022-04-01 2024-03-31 Oral 6 BLOOD FORMATION, COAGULATION AND THROMBOSIS
41 B1531 PRADAX 150MG TAB (BOE) DABIGATRAN (BQ) DABIGATRAN PRADAX 60'S BQ 193.27 3.2212 TAB 60 BOX BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD 20120412 DIRECT THROMBIN INHIBITORS 2024-04-01 2026-03-31 ORAL 6 DIRECT THROMBIN INHIBITORS
40 B1533 XARELTO 20MG TAB (BSP/AHI) RIVAROXABAN RIVAROXABAN XARELTO 28'S C 169.92 6.07 TABLET 0 TAB BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 20120412 DIRECT THROMBIN INHIBITORS 2022-04-01 2024-03-31 Oral 0 BLOOD FORMATION, COAGULATION AND THROMBOSIS
41 B1533 XARELTO 20MG TAB (BSP) RIVAROXABAN (C) RIVAROXABAN XARELTO 28'S C 169.92 6.0687 TAB 30 BOX BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 20120412 DIRECT THROMBIN INHIBITORS 2024-04-01 2026-03-31 ORAL 0 DIRECT THROMBIN INHIBITORS
40 B1534 XARELTO 20MG TAB (BSP/COL) RIVAROXABAN RIVAROXABAN XARELTO 28'S C 169.92 6.07 TABLET 0 TAB BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 20120412 DIRECT THROMBIN INHIBITORS 2022-04-01 2024-03-31 Oral 0 BLOOD FORMATION, COAGULATION AND THROMBOSIS
41 B1534 XARELTO 20MG TAB (BSP) RIVAROXABAN (C) RIVAROXABAN XARELTO 28'S C 169.92 6.0687 TAB 30 BOX BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 20120412 DIRECT THROMBIN INHIBITORS 2024-04-01 2026-03-31 ORAL 0 DIRECT THROMBIN INHIBITORS
40 B1535 XARELTO 20MG TAB (BSP/AHI) RIVAROXABAN RIVAROXABAN XARELTO 14'S C 84.97 6.07 TABLET 0 TAB BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 20120412 DIRECT THROMBIN INHIBITORS 2022-04-01 2024-03-31 Oral 0 BLOOD FORMATION, COAGULATION AND THROMBOSIS
41 B1535 XARELTO 20MG TAB (BSP) RIVAROXABAN (C) RIVAROXABAN XARELTO 14'S C 84.97 6.0696 TAB 30 BOX BSP BAYER SCHERING PHARMA AG. AHI ARMSTRONG HEALTHCARE INC 20120412 DIRECT THROMBIN INHIBITORS 2024-04-01 2026-03-31 ORAL 0 DIRECT THROMBIN INHIBITORS