Displaying 1 - 13 of 13
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 3961AS EPILIM CHRONO 133.2MG | 58MG TAB (SFA/COL) SODI SODIUM VALPROATE|VALPROIC ACID EPILIM CHRONO 30'S A 11.01 0.37 TABLET 150 TAB SFA SANOFI AVENTIS COL COLLINS LTD B 281292 ANTICONVULSANTS MISCELLANEOUS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
41 3961AS EPILIM CHRONO 133.2MG|58MG CR TAB (SFA) SODIUM VALPROATE|VAL SODIUM VALPROATE|VALPROIC ACID EPILIM CHRONO 30'S A 11.01 0.367 TABCR 150 BOX SFA SANOFI AVENTIS COL COLLINS LTD B 281292 ANTICONVULSANTS MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 ANTICONVULSANTS MISCELLANEOUS
42 3961BB VALEX 133.2MG|58MG CR TAB (INC) SODIUM VALPROATE|VALPROIC AC SODIUM VALPROATE|VALPROIC ACID VALEX 5X10 A 5.33 0.11 TAB 150 BLIS INC INCEPTA PHARMACEUTICALS LIMITED AHI ARMSTRONG HEALTHCARE INC B 281292 ANTICONVULSANTS MISCELLANEOUS 2026-04-01 ORAL 6 ANTICONVULSANTS MISCELLANEOUS
42 3961BG VALSONIM 133.2MG|58MG CR TAB (ANC) SODIUM VALPROATE|VALPROIC SODIUM VALPROATE|VALPROIC ACID VALSONIM 100'S A 8.92 0.09 TAB 150 ANC AEONIM HEALTHCARE SBI MASSY DISTRIBUTION (BDOS) LTD B 281292 ANTICONVULSANTS MISCELLANEOUS 2026-04-01 Add to Contract as Cat A ORAL 6 ANTICONVULSANTS MISCELLANEOUS 2026-01-30
42 3961BH LEEPORATE 133.2MG|58MG CR TAB (JLP) SODIUM VALPROATE|VALPROI SODIUM VALPROATE|VALPROIC ACID LEEPORATE 10X10 A 12.64 0.13 TAB 150 JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC B 281292 ANTICONVULSANTS MISCELLANEOUS 2026-04-01 Add to Contract as Cat A ORAL 6 ANTICONVULSANTS MISCELLANEOUS 2026-01-30
40 39634 EPILIM CHRONO 199.8MG | 87MG TAB (SFA/COL) SODI SODIUM VALPROATE|VALPROIC ACID EPILIM CHRONO 30'S A 14.95 0.50 TABLET 150 TAB SFA SANOFI AVENTIS COL COLLINS LTD B 281292 ANTICONVULSANTS MISCELLANEOUS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
41 39635 VALEX 199.8MG|87MG CR TAB (INC) SODIUM VALPROATE|VALPROIC AC SODIUM VALPROATE|VALPROIC ACID VALEX 3X10 A 13.16 0.4387 TABCR 90 BOX INC INCEPTA PHARMACEUTICALS LIMITED AHI ARMSTRONG HEALTHCARE INC A 281292 ANTICONVULSANTS MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 ANTICONVULSANTS MISCELLANEOUS 2023-10-03
42 39639 LEEPORATE CHRONO 199.8MG|87MG CR TAB (JLP) SODIUM VALPROATE| SODIUM VALPROATE|VALPROIC ACID LEEPORATE CHRONO 10X10 A 14.14 0.14 TAB 150 BLIS JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC B 281292 ANTICONVULSANTS MISCELLANEOUS 2026-04-01 ORAL 6 ANTICONVULSANTS MISCELLANEOUS
42 3963A VALSONIM 199.8MG|87MG CR TAB (ANC) SODIUM VALPROATE|VALPROIC SODIUM VALPROATE|VALPROIC ACID VALSONIM 100'S A 10.52 0.11 TAB 150 ANC AEONIM HEALTHCARE SBI MASSY DISTRIBUTION (BDOS) LTD B 281292 ANTICONVULSANTS MISCELLANEOUS 2026-04-01 Add to Contract as Cat A ORAL 6 ANTICONVULSANTS MISCELLANEOUS 2026-01-30
40 3965A EPILIM CHRONO 333MG | 145M TAB (SFA/COL) SODIUM VALPROATE | VALPROIC ACID SODIUM VALPROATE|VALPROIC ACID EPILIM CHRONO 30'S A 19.54 0.65 TABLET 150 TAB SFA SANOFI AVENTIS COL COLLINS LTD B 281292 ANTICONVULSANTS MISCELLANEOUS 2022-04-01 2024-03-31 Oral 6 CENTRAL NERVOUS SYSTEM DRUGS
41 3965A EPILIM CHRONO 333MG|145MG CR TAB (SFA) SODIUM VALPROATE|VALP SODIUM VALPROATE|VALPROIC ACID EPILIM CHRONO 30'S A 19.54 0.6515 TABCR 120 BOX SFA SANOFI AVENTIS COL COLLINS LTD B 281292 ANTICONVULSANTS MISCELLANEOUS 2024-04-01 2026-03-31 ORAL 6 ANTICONVULSANTS MISCELLANEOUS
42 3965G VALSONIM 500MG TAB (ANC) VALPROIC ACID SODIUM VALPROATE|VALPROIC ACID VALSONIM 100'S A 19.03 0.19 TAB 120 BLIS ANC AEONIM HEALTHCARE SBI MASSY DISTRIBUTION (BDOS) LTD B 281292 ANTICONVULSANTS MISCELLANEOUS 2026-04-01 Price Change ORAL 6 ANTICONVULSANTS MISCELLANEOUS 2026-02-05
42 3965L LEEPORATE CHRONO 333MG|145MG CR TAB (JLP) SODIUM VALPROATE|V SODIUM VALPROATE|VALPROIC ACID LEEPORATE CHRONO 10X10 A 15.22 0.15 TAB 120 BLIS JLP JOHN LEE PHARMACEUTICALS AHI ARMSTRONG HEALTHCARE INC B 281292 ANTICONVULSANTS MISCELLANEOUS 2026-04-01 ORAL 6 ANTICONVULSANTS MISCELLANEOUS