Displaying 1 - 20 of 90
| 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 | |||||
| 40 | 0231C | SYMBICORT TURBU 80MCG | 4.5MCG INHR (AZN/COL) BUDESONIDE | FORMOTEROL | BUDESONIDE|FORMOTEROL | SYMBICORT TURBU | 60 DOSES | A | 24.27 | 24.27 | 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 | 0231C | SYMBICORT TURBU 80MCG|4.5MCG INHR (AZN) BUDESONIDE|FORMOTERO | BUDESONIDE|FORMOTEROL | SYMBICORT TURBU | 60 DOSES | A | 24.27 | 24.2746 | 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 | ||||
| 40 | 0232D | SYMBICORT TURBU 160MCG | 4.5MCG INHR (AZN/COL) BUDESONIDE | FORMOTEROL (60) | BUDESONIDE|FORMOTEROL (60) | SYMBICORT TURBU | 60 DOSES | A | 32.62 | 32.62 | 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 | 0232D | SYMBICORT TURBU 160MCG|4.5MCG INHR (AZN) BUDESONIDE|FORMOTER | BUDESONIDE|FORMOTEROL (60) | SYMBICORT TURBU | 60 DOSES | A | 32.62 | 32.6199 | 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 | 0232D | SYMBICORT TURBU 160MCG|4.5MCG INHR (AZN) BUDESONIDE|FORMOTER | BUDESONIDE|FORMOTEROL (60) | SYMBICORT TURBU | 60 DOSES | A | 32.62 | 32.62 | INHR | 1 | BOX | AZN | ASTRAZENECA AB | COL | AVENTA BARBADOS | B | 4892 | RESPIRATORY AGENTS MISCELLANEOUS | 2026-04-01 | ORAL INHALATION | 6 | RESPIRATORY AGENTS MISCELLANEOUS | |||||
| 40 | 0232E | SYMBICORT RAPIHALER 160MCG | 4.5MCG INHR (AZN/COL) BUDESONIDE | FORMOTEROL (120 More ... | BUDESONIDE|FORMOTEROL (120 R) | SYMBICORT RAPIHALER | 120 DOSES | A | 37.68 | 37.68 | 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 | 0232E | SYMBICORT RAPIHALER 160MCG|4.5MCG INHR (AZN) BUDESONIDE|FORM | BUDESONIDE|FORMOTEROL (120 R) | SYMBICORT RAPIHALER | 120 DOSES | A | 37.68 | 37.676 | 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 | 0232E | SYMBICORT RAPIHALER 160MCG|4.5MCG INHR (AZN) BUDESONIDE|FORM | BUDESONIDE|FORMOTEROL (120 R) | SYMBICORT RAPIHALER | 120 DOSES | A | 37.68 | 37.68 | INHR | 1 | BOX | AZN | ASTRAZENECA AB | COL | AVENTA BARBADOS | B | 4892 | RESPIRATORY AGENTS MISCELLANEOUS | 2026-04-01 | ORAL INHALATION | 6 | RESPIRATORY AGENTS MISCELLANEOUS | |||||
| 40 | 0232F | SYMBICORT TURBU 160MCG | 4.5MCG INHR (AZN/COL) BUDESONIDE | FORMOTEROL (120) | BUDESONIDE|FORMOTEROL (120) | SYMBICORT TURBU | 120 DOSES | A | 44.31 | 44.31 | 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 | 0232F | SYMBICORT TURBU 160MCG|4.5MCG INHR (AZN) BUDESONIDE|FORMOTER | BUDESONIDE|FORMOTEROL (120) | SYMBICORT TURBU | 120 DOSES | A | 44.31 | 44.3087 | 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 | 0232F | SYMBICORT TURBU 160MCG|4.5MCG INHR (AZN) BUDESONIDE|FORMOTER | BUDESONIDE|FORMOTEROL (120) | SYMBICORT TURBU | 120 DOSES | A | 44.31 | 44.31 | INHR | 1 | BOX | AZN | ASTRAZENECA AB | COL | AVENTA BARBADOS | B | 4892 | RESPIRATORY AGENTS MISCELLANEOUS | 2026-04-01 | ORAL INHALATION | 6 | RESPIRATORY AGENTS MISCELLANEOUS | |||||
| 40 | 02335 | SYMBICORT TURBU 320MCG | 9MCG INHR (AZN/COL) BUDESONIDE | FORMOTEROL | BUDESONIDE|FORMOTEROL | SYMBICORT TURBU | 60 DOSES | A | 52.19 | 52.19 | 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 | 02335 | SYMBICORT TURBU 320MCG|9MCG INHR (AZN) BUDESONIDE|FORMOTEROL | BUDESONIDE|FORMOTEROL | SYMBICORT TURBU | 60 DOSES | A | 52.19 | 52.1918 | 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 | 02335 | SYMBICORT TURBU 320MCG|9MCG INHR (AZN) BUDESONIDE|FORMOTEROL | BUDESONIDE|FORMOTEROL | SYMBICORT TURBU | 60 DOSES | A | 52.19 | 52.19 | INHR | 1 | BOX | AZN | ASTRAZENECA AB | COL | AVENTA BARBADOS | B | 4892 | RESPIRATORY AGENTS MISCELLANEOUS | 2026-04-01 | ORAL INHALATION | 6 | RESPIRATORY AGENTS MISCELLANEOUS | |||||
| 40 | 0884BD | PULMICORT 0.25MG/ML RESP SOL (AZN/COL) BUDESO | BUDESONIDE | PULMICORT | 20X2ML | A | 40.77 | 2.04 | RESPIRATORY | 20 | AMP | AZN | ASTRAZENECA AB | COL | COLLINS LTD | B | 481008 | CORTICOSTEROIDS (RESPIRATORY) | 2022-04-13 | 2024-03-31 | Add to Contract as Cat A | ORAL INHALATION | 6 | RESPIRATORY TRACT AGENTS | 2022-04-13 | ||
| 40 | 0884BE | PULMICORT 0.5MG/ML RESP SOL (AZN/COL) BUDESON | BUDESONIDE | PULMICORT | 20X2ML | A | 46.21 | 2.31 | RESPIRATORY | 20 | AMP | AZN | ASTRAZENECA AB | COL | COLLINS LTD | B | 481008 | CORTICOSTEROIDS (RESPIRATORY) | 2022-04-13 | 2024-03-31 | Add to Contract as Cat A | ORAL INHALATION | 6 | RESPIRATORY TRACT AGENTS | 2022-04-13 | ||
| 41 | 0884BE | PULMICORT 0.5MG/ML RESP SOL (AZN) BUDESONIDE | BUDESONIDE | PULMICORT | 20X2ML | A | 41.59 | 2.0795 | AMPP | 20 | CAR | AZN | ASTRAZENECA AB | COL | COLLINS LTD | B | 48120412 | SELECTIVE BETA2 ADRENERGIC AGONIST (RESPIRATORY) | 2024-04-01 | 2026-03-31 | ORAL INHALATION | 6 | SELECTIVE BETA2 ADRENERGIC AGONIST (RESPIRA | ||||