Displaying 1 - 3 of 3
  • 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 0231B SYMBICORT RAPIHALER 80MCG | 4.5MCG INHR (AZN/COL) BUDESONIDE | FORMOTEROL (R) BUDESONIDE|FORMOTEROL (R) SYMBICORT RAPIHALER 120 DOSES A 35.23 35.23 INHALER 1 INHR AZN ASTRAZENECA AB COL COLLINS LTD B 4892 RESPIRATORY AGENTS MISCELLANEOUS 2022-04-01 2024-03-31 ORAL INHALATION 6 RESPIRATORY TRACT AGENTS
41 0231B SYMBICORT RAPIHALER 80MCG|4.5MCG INHR (AZN) BUDESONIDE|FORMO BUDESONIDE|FORMOTEROL (R) SYMBICORT RAPIHALER 120 DOSES A 35.23 35.2295 INHR 1 BOX AZN ASTRAZENECA AB COL COLLINS LTD B 4892 RESPIRATORY AGENTS MISCELLANEOUS 2024-04-01 2026-03-31 ORAL INHALATION 6 RESPIRATORY AGENTS MISCELLANEOUS
42 0231B SYMBICORT RAPIHALER 80MCG|4.5MCG INHR (AZN) BUDESONIDE|FORMO BUDESONIDE|FORMOTEROL (R) SYMBICORT RAPIHALER 120 DOSES A 35.23 35.23 INHR 1 BOX AZN ASTRAZENECA AB COL AVENTA BARBADOS B 4892 RESPIRATORY AGENTS MISCELLANEOUS 2026-04-01 ORAL INHALATION 6 RESPIRATORY AGENTS MISCELLANEOUS