Displaying 5601 - 5620 of 5993
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 A9624 DIFFERIN PUMP 0.3% GEL (DPT/STO) ADAPALENE ADAPALENE DIFFERIN PUMP 45G C 204.74 204.74 GEL 0 BOTT DPT DPT LABORATORIES INC/GALDERMA STO BRYDEN STOKES LTD 8428 KERATOLYTICS 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
41 A9626 ADAPALENE 0.6% GEL (WAT) (C) ADAPALENE ADAPALENE 45G C 169.2157 169.2157 TUBE 0 TUBE WAT WATSON (ACTAVIS) PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC 8428 KERATOLYTICS 2024-04-01 2026-03-31 TOPICAL 0 KERATOLYTICS
42 A9628 DERIVA 0.1% GEL (GLP) ADAPALENE (C) ADAPALENE DERIVA 45G C 14.95 14.95 TUBE 0 TUBE GLP GLENMARK PHARMACEUTICALS LTD AHI ARMSTRONG HEALTHCARE INC 8428 KERATOLYTICS 2026-04-01 2028-03-31 TOPICAL 0 KERATOLYTICS
40 A9631 DIFFERIN 0.1% CR (DPT/STO) ADAPALENE ADAPALENE DIFFERIN 45G C 65.86 65.86 CREAM 0 TUBE DPT DPT LABORATORIES INC/GALDERMA STO BRYDEN STOKES LTD 8428 KERATOLYTICS 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
40 A9632 DERIVA 0.1% CR (GLP/ALI) ADAPALENE ADAPALENE DERIVA 15G C 16.31 16.31 CREAM 0 TUBE GLP GLENMARK PHARMACEUTICALS LTD ALI ALL HEALTH INC 8428 KERATOLYTICS 2022-04-01 2022-03-22 Delete from contract TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS 2022-03-22
40 A9634 DERIVA 0.1% GEL (GLN/ALI) ADAPALENE ADAPALENE DERIVA 45G C 29.90 29.90 GEL 0 TUBE GLN GLAND ALI ALL HEALTH INC 8428 KERATOLYTICS 2022-04-01 2024-03-31 TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS
40 A9635 DERIVA 0.1% CR (GLP/ATB) ADAPALENE ADAPALENE DERIVA 15G C 16.31 16.31 CREAM 0 TUBE GLP GLENMARK PHARMACEUTICALS LTD ATB ANSA TRADING BARBADOS LTD 8428 KERATOLYTICS 2022-04-01 2024-03-31 Change Local Agent TOPICAL 0 SKIN-MUCOUS MEMBRANE PREPARATIONS 2022-03-22
41 A9811 HYPERIUM 1MG TAB (SER) RILMENIDINE (C) RILMENIDINE HYPERIUM 30'S C 22.15 0.7385 TAB 60 BOX SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD B 240892 HYPOTENSIVE AGENTS, MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 HYPOTENSIVE AGENTS, MISCELLANEOUS
41 A9812 HYPERIUM 1MG TAB (SER) RILMENIDINE (C) RILMENIDINE HYPERIUM 30'S C 22.15 0.7385 TAB 60 BOX SER LES LABORATOIRES SERVIER COL COLLINS LTD B 240892 HYPOTENSIVE AGENTS, MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 HYPOTENSIVE AGENTS, MISCELLANEOUS
40 A9813 RILMENIDINE 1MG TAB (KWA/ATB) RILMENIDINE RILMENIDINE 3X10 C 97.86 3.26 TABLET 0 TAB KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 240892 HYPOTENSIVE AGENTS, MISCELLANEOUS 2022-04-01 2024-03-31 Oral 0 CARDIOVASCULAR DRUGS
41 A992P TOLTERODINE XL 2MG SR TAB (TEV) (C) TOLTERODINE TOLTERODINE XL 28'S C 12.56 0.4485 TABSR 0 BOTT TEV TEVA UK LTD. COL COLLINS LTD 1208 ANTICHOLINERGIC AGENTS 2024-04-01 2026-03-31 ORAL 0 ANTICHOLINERGIC AGENTS
40 A992Q DETRUSITOL SR 2MG TAB (PFI/STO) TOLTERODINE TOLTERODINE DETRUSITOL SR 30'S C 66.54 2.22 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 120808 ANTIMUSCARINICS/ANTISPASMODICS 2022-04-01 2024-03-31 Oral 0 AUTONOMIC DRUGS
41 A992Q DETRUSITOL 2MG SR TAB (PFI) TOLTERODINE (C) TOLTERODINE DETRUSITOL 30'S C 67.14 2.2381 TABSR 0 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 1208 ANTICHOLINERGIC AGENTS 2024-04-01 2026-03-31 ORAL 0 ANTICHOLINERGIC AGENTS
40 A992R DETRUSITOL SR 2MG TAB (PFI/SBI) TOLTERODINE TOLTERODINE DETRUSITOL SR 30'S C 66.54 2.22 TABLET 0 TAB PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 120808 ANTIMUSCARINICS/ANTISPASMODICS 2022-04-01 2024-03-31 Oral 0 AUTONOMIC DRUGS
41 A992R DETRUSITOL 2MG SR TAB (PFI) TOLTERODINE (C) TOLTERODINE DETRUSITOL 30'S C 67.14 2.2381 TABSR 0 BOX PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 1208 ANTICHOLINERGIC AGENTS 2024-04-01 2026-03-31 ORAL 0 ANTICHOLINERGIC AGENTS
42 A992S DETRUSITOL 2MG SR CAP (PFI) TOLTERODINE TOLTERODINE DETRUSITOL 30'S C 67.14 2.24 CAP 0 BLIS PFI PFIZER CORPORATION COL AVENTA BARBADOS 1208 ANTICHOLINERGIC AGENTS 2026-04-01 2028-03-31 ORAL 0 ANTICHOLINERGIC AGENTS
40 A9933 DETRUSITOL SR 4MG TAB (PFI/SBI) TOLTERODINE TOLTERODINE DETRUSITOL SR 30'S C 133.06 4.44 TABLET 0 TAB PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 120808 ANTIMUSCARINICS/ANTISPASMODICS 2022-04-01 2024-03-31 Oral 0 AUTONOMIC DRUGS
40 A993G DETRUSITOL 4MG TAB (PFI/STO) TOLTERODINE TOLTERODINE DETRUSITOL 30'S C 133.06 4.44 TABLET 0 TAB PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 120808 ANTIMUSCARINICS/ANTISPASMODICS 2022-04-01 2024-03-31 Oral 0 AUTONOMIC DRUGS
41 A993G DETRUSITOL 4MG TAB (PFI) TOLTERODINE (C) TOLTERODINE DETRUSITOL 30'S C 134.26 4.4753 TAB 0 BOX PFI PFIZER CORPORATION STO BRYDEN STOKES LTD 1208 ANTICHOLINERGIC AGENTS 2024-04-01 2026-03-31 ORAL 0 ANTICHOLINERGIC AGENTS
41 A993H DETRUSITOL LA 4MG CAP (PFI) TOLTERODINE (C) TOLTERODINE DETRUSITOL LA 30'S C 134.26 4.4753 CAP 0 BOX PFI PFIZER CORPORATION SBI MASSY DISTRIBUTION (BDOS) LTD 1208 ANTICHOLINERGIC AGENTS 2024-04-01 2026-03-31 ORAL 0 ANTICHOLINERGIC AGENTS