Displaying 4161 - 4180 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
41 B2256 NOVOMIX 70|30 FLEXPENS 100U/ML INJ (NOV) ASPART INSULIN ASPART NOVOMIX 70|30 FLEXPENS 5X3ML A 122.32 24.464 BOX 2 VIAL NOV NOVO NORDISK A/S COL COLLINS LTD B 682008 INSULINS 2024-04-01 2026-03-31 SC 6 INSULINS 2024-03-05
41 B2258 HUMALOG 75%|25% INJ (LIL) INSULIN ISOPHANE|INSULIN REGULAR (C) INSULIN ISOPHANE|INSULIN RAPID HUMALOG 5X3ML C 134.69 26.9386 VIAL 0 BOX LIL ELI LILLY S.A.(PUERTO RICO BRA) STO BRYDEN STOKES LTD 682008 INSULINS 2024-04-01 2026-03-31 SC 0 INSULINS
40 B225A HUMULIN CARTRIDGE 70% | 30% INJ (LIL/STO) INSULIN ISOPHANE | INSULIN REGULAR INSULIN ISOPHANE|INSULIN REGULAR HUMULIN CARTRIDGE 5X3ML A 47.03 9.41 INJECTION 5 VIAL LIL ELI LILLY S.A.(PUERTO RICO BRA) STO BRYDEN STOKES LTD B 682008 INSULINS 2022-04-01 2024-03-31 SC 6 HORMONES AND SYNTHETIC SUBSTITUTES
41 B225A HUMULIN CARTRIDGE 70%|30% INJ (LIL) INSULIN ISOPHANE|INSULIN (C) INSULIN ISOPHANE|INSULIN REGULAR HUMULIN CARTRIDGE 5X3ML C 52.41 52.41 CAR 5 VIAL LIL ELI LILLY S.A.(PUERTO RICO BRA) STO BRYDEN STOKES LTD 682008 INSULINS 2024-04-01 2026-03-31 SC 6 INSULINS
40 B225B NOVOLIN PENFIL 70% | 30% INJ (NOV/COL) INSULIN ISOPHANE | INSULIN REGULAR INSULIN ISOPHANE|INSULIN REGULAR NOVOLIN PENFIL 5X3ML C 61.19 12.24 INJECTION 0 VIAL NOV NOVO NORDISK A/S COL COLLINS LTD B 682008 INSULINS 2022-04-01 2024-03-31 SC 0 HORMONES AND SYNTHETIC SUBSTITUTES
41 B225B NOVOLIN PENFIL 70%|30% INJ (NOV) INSULIN ISOPHANE|INSULIN RE (C) INSULIN ISOPHANE|INSULIN REGULAR NOVOLIN PENFIL 5X3ML C 61.16 12.2325 VIAL 5 BOX NOV NOVO NORDISK A/S COL COLLINS LTD 682008 INSULINS 2024-04-01 2026-03-31 SC 6 INSULINS
41 B225D HUMALOG KWIKPEN 75%|25% INJ (LIL) INSULIN ISOPHANE|INSULIN R (C) INSULIN ISOPHANE|INSULIN RAPID HUMALOG KWIKPEN 5X3ML C 139.29 27.8574 VIAL 0 BOX LIL ELI LILLY S.A.(PUERTO RICO BRA) STO BRYDEN STOKES LTD B 682008 INSULINS 2024-04-01 2026-03-31 SC 6 INSULINS
40 B2712 GALVUS 50MG TAB (NVS/COL) VIDAGLIPTIN VIDAGLIPTIN GALVUS 56'S B 32.62 0.58 TABLET 60 TAB NVS NOVARTIS CARIBE SA COL COLLINS LTD B 682005 DIPEPTIDYL PEPTIDASE INHIBITORS 2022-04-01 2024-03-31 Oral 6 HORMONES AND SYNTHETIC SUBSTITUTES
41 B2712 GALVUS 50MG TAB (NVS) VILDAGLIPTIN (C) VILDAGLIPTIN GALVUS 56'S C 32.62 0.5825 TAB 60 BOX NVS NOVARTIS CARIBE SA COL COLLINS LTD B 682005 DIPEPTIDYL PEPTIDASE INHIBITORS 2024-04-01 2026-03-31 ORAL 6 DIPEPTIDYL PEPTIDASE INHIBITORS
40 B2713 JANUVIA 50MG TAB (MSD/STO) SITAGLIPTIN SITAGLIPTIN JANUVIA 28'S C 70.65 2.52 TABLET 0 TAB MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 682005 DIPEPTIDYL PEPTIDASE INHIBITORS 2022-04-01 2024-03-31 Oral 0 HORMONES AND SYNTHETIC SUBSTITUTES
41 B2713 JANUVIA 50MG TAB (MSD) SITAGLIPTIN (C) SITAGLIPTIN JANUVIA 28'S C 67.12 2.397 TAB 0 BOX MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 682005 DIPEPTIDYL PEPTIDASE INHIBITORS 2024-04-01 2026-03-31 ORAL 0 DIPEPTIDYL PEPTIDASE INHIBITORS
40 B2714 JANUVIA 100MG TAB (MSD/STO) SITAGLIPTIN SITAGLIPTIN JANUVIA 28'S C 70.65 2.52 TABLET 0 TAB MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 682005 DIPEPTIDYL PEPTIDASE INHIBITORS 2022-04-01 2024-03-31 Oral 0 HORMONES AND SYNTHETIC SUBSTITUTES
41 B2714 JANUVIA 100MG TAB (MSD) SITAGLIPTIN (C) SITAGLIPTIN JANUVIA 28'S C 67.12 2.397 TAB 0 BOX MSD MERCK SHARP & DOHME (I.A.) CORP STO BRYDEN STOKES LTD 682005 DIPEPTIDYL PEPTIDASE INHIBITORS 2024-04-01 2026-03-31 ORAL 0 DIPEPTIDYL PEPTIDASE INHIBITORS
41 B271E REMEVIA 100MG TAB (REM) SITAGLIPTIN (C) SITAGLIPTIN REMEVIA 28'S C 11.93 0.4262 TAB 0 BOX REM REMEDICA LTD SBI MASSY DISTRIBUTION (BDOS) LTD 682005 DIPEPTIDYL PEPTIDASE INHIBITORS 2024-04-01 2026-03-31 ORAL 0 DIPEPTIDYL PEPTIDASE INHIBITORS
41 B271G VILDAGLIPTIN 50MG TAB (MCP) (B) VILDAGLIPTIN VILDAGLIPTIN 3X10 B 11.15 0.3715 TAB 60 BOX MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC B 682005 DIPEPTIDYL PEPTIDASE INHIBITORS 2024-04-01 2024-05-14 ORAL 6 DIPEPTIDYL PEPTIDASE INHIBITORS 2024-04-02
41 B271R VILDAGLIPTIN 50MG TAB (MCP) VILDAGLIPTIN VILDAGLIPTIN 56'S B 22.29 0.398 TAB 60 BOX MCP MACLEODS PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC B 682005 DIPEPTIDYL PEPTIDASE INHIBITORS 2024-04-03 2026-03-31 ORAL 6 DIPEPTIDYL PEPTIDASE INHIBITORS 2024-04-03
40 B4213 JARDIANCE 10MG TAB (BOE/STO) EMPAGLIFLOZIN EMPAGLIFLOZIN JARDIANCE 30'S A 67.25 2.24 TABLET 60 TAB BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD B 682018 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2022-04-01 2024-03-31 Oral 6 HORMONES AND SYNTHETIC SUBSTITUTES
41 B4213 JARDIANCE 10MG TAB (BOE) EMPAGLIFLOZIN EMPAGLIFLOZIN JARDIANCE 30'S A 67.25 2.2417 TAB 60 BOX BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD B 682018 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2024-04-01 2026-03-31 ORAL 6 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR
40 B4214 JARDIANCE 25MG TAB (BOE/STO) EMPAGLIFLOZIN EMPAGLIFLOZIN JARDIANCE 30'S A 67.25 2.24 TABLET 30 TAB BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD B 682018 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2022-04-01 2024-03-31 Oral 6 HORMONES AND SYNTHETIC SUBSTITUTES
41 B4214 JARDIANCE 25MG TAB (BOE) EMPAGLIFLOZIN EMPAGLIFLOZIN JARDIANCE 30'S A 67.25 2.2417 TAB 30 BOX BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD B 682018 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR 2024-04-01 2026-03-31 ORAL 6 SODIUM-GLUCOSE COTRANSPORTER INHIBITOR