Displaying 2301 - 2320 of 5993
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 3582F SODIUM BICARBONATE 8.4% INJ (KWA) (B) 50ML B 4.4037 8.4% 70 2024-04-01 2026-03-31 0
42 3582G SODIUM BICARBONATE 8.4% INJ (KWA) 50ML B 5.03 8.4% 70 2026-04-01 No No Add to Contract as Cat B 0
40 35831 SODIUM BICARBONATE 8.4% INJ (FSB/ATB) 10ML B 1.14 8.4% 0 2022-04-01 2024-03-31 0
41 35831 SODIUM BICARBONATE 8.4% INJ (FSB) 10ML B 1.1961 8.4% 70 2024-04-01 2026-03-31 0
42 35833 SODIUM BICARBONATE 8.4% INJ (FSB) 10ML B 1.09 8.4% 70 2026-04-01 No No Add to Contract as Cat B 0
42 35861 SODIUM BICARBONATE 4.2% INJ (MTP) 10X10ML B 10.34 4.2% 0 2026-04-01 No No 0
40 35911 LAMICTAL 25MG TAB (GSK/COL) LAMOTRIGINE 30'S C 1.38 25MG 0 2022-04-01 2024-03-31 0
41 35911 LAMICTAL 25MG TAB (GSK) LAMOTRIGINE (C) 30'S C 1.5159 25MG 60 2024-04-01 2026-03-31 6
42 35911 LAMICTAL 25MG TAB (GSK) LAMOTRIGINE 30'S C 1.59 25MG 60 2026-04-01 No No 6
42 3591F APO-LAMOTRIGINE 25MG TAB (APO) LAMO 100'S B 0.10 25MG 60 2026-04-01 No No 6
40 3591G PMS-LAMOTRIGINE 25MG TAB (PMS/COL) 100'S B 0.14 25MG 0 2022-04-01 2024-03-31 6
41 3591Q APO-LAMOTRIGINE 25MG TAB (APO) LAMO (B) 100'S B 0.1041 25MG 60 2024-04-01 2026-03-31 6
42 3591T LEMOGIN 25MG DISP TAB (JLP) LAMOTRIGINE 20X10 B 0.12 25MG 0 2026-04-01 No No 0
40 35921 LAMICTAL 50MG TAB (GSK/COL) LAMOTRIGINE 30'S C 2.71 50MG 0 2022-04-01 2024-03-31 0
41 35921 LAMICTAL 50MG TAB (GSK) LAMOTRIGINE (B) 30'S B 2.9784 50MG 60 2024-04-01 2026-03-31 6
42 35921 LAMICTAL 50MG TAB (GSK) LAMOTRIGINE 30'S C 3.28 50MG 60 2026-04-01 No No 6
40 3592D LAMEZ 50MG TAB (INP/AAL) LAMOTRIGINE 56'S B 1.04 50MG 0 2022-04-01 2024-03-31 6
42 3592G LEMOGIN 50MG DISP TAB (JLP) LAMOTRIGINE 20X10 B 0.12 50MG 0 2026-04-01 No No 0
40 35931 LAMICTAL 100MG TAB (GSK/COL) LAMOTRIGINE 30'S C 2.98 100MG 0 2022-04-01 2024-03-31 0
41 35931 LAMICTAL 100MG TAB (GSK) LAMOTRIGINE (C) 30'S C 3.2801 100MG 60 2024-04-01 2026-03-31 6