Displaying 1 - 20 of 5395
Contract Number Brand Code Brand Name Package Size Formulary Category Unit Price Strength Max. Reimbursable / Month Drug Contract Start Date Drug Contract End Date Restrict To Ophthalmologist Restrict To Pulmonologist Status Description Max Repeats
41 0011AA CHLORPHENIRAMINE 4MG TAB (GPC/ATB) 1000'S A 0.0169 4MG 84 0
41 0011M HISTAL 4MG TAB (CAR/COL) CHLORPHENIRAMINE 1000'S A 0.0334 4MG 84 0
40 0011M HISTAL 4MG TAB (CAR/COL) CHLORPHENIRAMINE 1000'S A 0.03 4MG 84 2022-04-01 2024-03-31 0
40 0012AB ALLEGRA 120MG TAB (SFA/COL) FEXOFENADINE 10'S C 0.95 120MG 0 2022-04-01 2024-03-31 0
40 0012AB ALLEGRA 120MG TAB (SFA/COL) FEXOFENADIN (C) 10'S C 1.631 120MG 2022-12-10 2024-03-31 No No Price Change 0
41 0012AN MEQUILAN 5MG TAB (CAR/COL) MEQUITAZINE 112'S A 0.3786 5MG 28 0
40 0012AN MEQUILAN 5MG TAB (CAR/COL) MEQUITAZINE 112'S A 0.38 5MG 28 2022-04-01 2024-03-31 0
40 0012AQ ALLEGRA 180MG TAB (SFA/COL) FEXOFENADINE 10'S C 1.02 180MG 0 2022-04-01 2024-03-31 0
40 0012AQ ALLEGRA 180MG TAB (SFA/COL) FEXOFENADIN (C) 10'S C 2.419 180MG 2022-12-10 2024-03-31 No No Price Change 0
40 0012BA APO-CETIRIZINE 10MG TAB (APO/COL) 100'S A 0.08 10MG 14 2022-04-01 2024-03-31 0
40 0012BB APO-LORATADINE 10MG TAB (APO/COL) 100'S A 0.09 10MG 14 2022-04-01 2024-03-31 0
41 0012BK REMIDINE 10MG TAB (REM/SBI) LORATADINE 2x10 A 0.0843 10MG 14 0
40 0012BK REMIDINE 10MG TAB (REM/SBI) LORATADINE 2x10 A 0.09 10MG 14 2022-04-01 2024-03-31 0
41 0012EA
41 0012EA
41 0012EA
41 0012EA DESLORA-DENK 5MG TAB (EDK/COL) DESLORATADINE 10'S C 0.2066 5MG 0 0
40 0012EA DESLORA-DENK 5MG TAB (EDK/COL) DESLORATADINE 10'S C 0.31 5MG 0 2022-04-01 2024-03-31 0
40 0012EJ LORATADINE 10MG TAB (KWA/ATB) 10X10 A 0.05 10MG 14 2022-04-01 2024-03-31 0
41 0012EP