Displaying 1 - 15 of 15
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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 5851AC DIVENIS 450MG | 50MG TAB (BCH/AHI) DIOSMIN | HESP DIOSMIN|HESPERIDIN DIVENIS 60'S C 25.50 0.43 TABLET 0 TAB BCH SANDOZ AHI ARMSTRONG HEALTHCARE INC 9300 VASOACTIVE DRUGS 2022-04-01 2024-03-31 Oral 0 VASOACTIVE DRUGS
41 5851AC DIVENIS 450MG|50MG TAB (BCH) DIOSMI (C) DIOSMIN|HESPERIDIN DIVENIS 60'S C 28.54 0.4757 TAB 0 BOX BCH SANDOZ AHI ARMSTRONG HEALTHCARE INC 9300 VASOACTIVE DRUGS 2024-04-01 2026-03-31 ORAL 0 VASOACTIVE DRUGS
41 5851AE FLOMACOR 900MG|100MG TAB (MPI) DIOSMIN|HESPERIDIN (C) DIOSMIN|HESPERIDIN FLOMACOR 3X10 C 24.41 0.8137 TAB 0 BOX MPI MEPRO PHARMACEUTICALS INTERNATIONAL LTD AHI ARMSTRONG HEALTHCARE INC 9300 VASOACTIVE DRUGS 2024-04-01 2026-03-31 ORAL 0 VASOACTIVE DRUGS
40 5851R DAFLON 450MG | 50MG TAB (SER/STO) DIOSMIN | HESPERIDIN DIOSMIN|HESPERIDIN DAFLON 60'S C 33.46 0.56 TABLET 0 TAB SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 9300 VASOACTIVE DRUGS 2022-04-01 2024-03-31 Oral 0 VASOACTIVE DRUGS
41 5851R DAFLON 450MG|50MG TAB (SER) DIOSMIN|HESPERIDIN (C) DIOSMIN|HESPERIDIN DAFLON 60'S C 33.46 0.5577 TAB 0 BOX SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 9300 VASOACTIVE DRUGS 2024-04-01 2026-03-31 ORAL 0 VASOACTIVE DRUGS
42 5851R DAFLON 450MG|50MG TAB (SER) DIOSMIN|HESPERIDIN DIOSMIN|HESPERIDIN DAFLON 60'S C 33.46 0.56 TAB 0 BLIS SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 9300 VASOACTIVE DRUGS 2026-04-01 ORAL 0 VASOACTIVE DRUGS
40 5851S DAFLON 450MG | 50MG TAB (SER/COL) DIOSMIN | HESPERIDIN DIOSMIN|HESPERIDIN DAFLON 60'S C 33.46 0.56 TABLET 0 TAB SER LES LABORATOIRES SERVIER COL COLLINS LTD 9300 VASOACTIVE DRUGS 2022-04-01 2024-03-31 Oral 0 VASOACTIVE DRUGS
41 5851S DAFLON 450MG|50MG TAB (SER) DIOSMIN|HESPERIDIN (C) DIOSMIN|HESPERIDIN DAFLON 60'S C 33.46 0.5577 TAB 0 BOX SER LES LABORATOIRES SERVIER COL COLLINS LTD 9300 VASOACTIVE DRUGS 2024-04-01 2026-03-31 ORAL 0 VASOACTIVE DRUGS
42 5851S DAFLON 450MG|50MG TAB (SER) DIOSMIN|HESPERIDIN DIOSMIN|HESPERIDIN DAFLON 60'S C 33.46 0.56 TAB 0 BLIS SER LES LABORATOIRES SERVIER COL AVENTA BARBADOS 9300 VASOACTIVE DRUGS 2026-04-01 ORAL 0 VASOACTIVE DRUGS
40 5851V DAFLON 900MG | 100MG TAB (SER/STO) DISOMIN | HESPERIDIN DIOSMIN|HESPERIDIN DAFLON 30'S C 33.46 1.12 TABLET 0 TAB SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 9300 VASOACTIVE DRUGS 2022-04-01 2024-03-31 Oral 0 VASOACTIVE DRUGS
41 5851V DAFLON 900MG|100MG TAB (SER) DISOMIN|HESPERIDIN (C) DIOSMIN|HESPERIDIN DAFLON 30'S C 33.46 1.1154 TAB 0 BOX SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 9300 VASOACTIVE DRUGS 2024-04-01 2026-03-31 ORAL 0 VASOACTIVE DRUGS
42 5851V DAFLON 900MG|100MG TAB (SER) DISOMIN|HESPERIDIN DIOSMIN|HESPERIDIN DAFLON 30'S C 33.46 1.12 TAB 0 BLIS SER LES LABORATOIRES SERVIER STO BRYDEN STOKES LTD 9300 VASOACTIVE DRUGS 2026-04-01 ORAL 0 VASOACTIVE DRUGS
40 5851W DAFLON 900MG | 100MG TAB (SER/COL) DISOMIN | HESPERIDIN DIOSMIN|HESPERIDIN DAFLON 30'S C 33.46 1.12 TABLET 0 TAB SER LES LABORATOIRES SERVIER COL COLLINS LTD 9300 VASOACTIVE DRUGS 2022-04-01 2024-03-31 Oral 0 VASOACTIVE DRUGS
41 5851W DAFLON 900MG|100MG TAB (SER) DISOMIN|HESPERIDIN (C) DIOSMIN|HESPERIDIN DAFLON 30'S C 33.46 1.1154 TAB 0 BOX SER LES LABORATOIRES SERVIER COL COLLINS LTD 9300 VASOACTIVE DRUGS 2024-04-01 2026-03-31 ORAL 0 VASOACTIVE DRUGS
42 5851W DAFLON 900MG|100MG TAB (SER) DISOMIN|HESPERIDIN DIOSMIN|HESPERIDIN DAFLON 30'S C 33.46 1.12 TAB 0 BLIS SER LES LABORATOIRES SERVIER COL AVENTA BARBADOS 9300 VASOACTIVE DRUGS 2026-04-01 ORAL 0 VASOACTIVE DRUGS