|
|
42
|
35931
|
LAMICTAL 100MG TAB (GSK) LAMOTRIGINE
|
30'S
|
C
|
3.44
|
100MG
|
60
|
2026-04-01
|
|
No
|
No
|
|
6
|
|
|
40
|
3593G
|
APO-LAMOTRIGINE 100MG TAB (APO/COL)
|
100'S
|
B
|
0.26
|
100MG
|
0
|
2022-04-01
|
2024-03-31
|
|
|
|
6
|
|
|
41
|
3593M
|
APO-LAMOTRIGINE 100MG TAB (APO) LAM (B)
|
100'S
|
B
|
0.2645
|
100MG
|
60
|
2024-04-01
|
2026-03-31
|
|
|
|
6
|
|
|
42
|
3593N
|
LEMOGIN 100MG DISP TAB (JLP) LAMOTRIGINE
|
20X10
|
B
|
0.13
|
100MG
|
0
|
2026-04-01
|
|
No
|
No
|
|
0
|
|
|
40
|
3621B
|
APO-LEVOCARB 10MG | 100MG TAB (APO/COL)
|
100'S
|
A
|
0.17
|
10MG|100MG
|
240
|
2022-04-01
|
2024-03-31
|
|
|
Add to Contract as Cat A
|
6
|
|
|
42
|
3621B
|
APO-LEVOCARB 10MG|100MG TAB (APO)
|
100'S
|
A
|
0.23
|
10MG|100MG
|
240
|
2026-04-01
|
|
No
|
No
|
|
6
|
|
|
41
|
3621G
|
APO-LEVOCARB 10MG|100MG TAB (APO)
|
100'S
|
A
|
0.2253
|
10MG|100MG
|
240
|
2024-04-01
|
2026-03-31
|
|
|
|
6
|
|
|
41
|
36222
|
SINEMET 25MG|250MG TAB (MSD) CARBIDOPA|L (C)
|
100'S
|
C
|
0.7997
|
25MG|250MG
|
240
|
2024-04-01
|
2026-03-31
|
|
|
|
6
|
|
|
40
|
36223
|
PROLOPA 50MG | 200MG TAB (ROC/AHI) BENSERAZIDE |
|
30'S
|
A
|
1.36
|
50MG|200MG
|
240
|
2022-04-01
|
2024-03-31
|
|
|
|
6
|
|
|
41
|
36223
|
PROLOPA 50MG|200MG TAB (ROC) BENSERAZIDE|LEVODOPA
|
30'S
|
A
|
1.005
|
50MG|200MG
|
240
|
2024-09-27
|
2026-03-31
|
|
|
|
6
|
|
|
40
|
36227
|
APO-LEVOCARB 25MG | 250MG TAB (APO/COL)
|
100'S
|
A
|
0.27
|
25MG|250MG
|
240
|
2022-04-01
|
2024-03-31
|
|
|
Add to Contract as Cat A
|
6
|
|
|
41
|
3622K
|
CREDANIL 25MG|250MG TAB (REM) CARBIDOPA|
|
50'S
|
A
|
0.2267
|
25MG|250MG
|
240
|
2024-04-01
|
2026-03-31
|
|
|
|
6
|
|
|
42
|
3622K
|
CREDANIL 25MG|250MG TAB (REM) CARBIDOPA|LEVODOPA
|
50'S
|
A
|
0.23
|
25MG|250MG
|
240
|
2026-04-01
|
|
No
|
No
|
|
6
|
|
|
41
|
3622R
|
APO-LEVOCARB 25MG|250MG TAB (APO)
|
100'S
|
A
|
0.2561
|
25MG|250MG
|
240
|
2024-04-01
|
2026-03-31
|
|
|
|
6
|
|
|
42
|
3622V
|
BENKINSON 50MG|200MG CAP (INC) BENSERAZIDE|LEVODOPA
|
20'S
|
A
|
0.79
|
50MG|200MG
|
240
|
2026-04-01
|
|
No
|
No
|
|
6
|
|
|
40
|
3631AX
|
ACCORD METOCLOPRAMIDE 10MG TAB (INP/AAL) METO
|
30'S
|
A
|
0.07
|
10MG
|
90
|
2022-04-01
|
2024-03-31
|
|
|
|
6
|
|
|
40
|
3631BB
|
METOCLOPRAMIDE 10MG TAB (FSB/ATB)
|
500'S
|
A
|
0.04
|
10MG
|
90
|
2022-04-01
|
2024-03-31
|
|
|
|
6
|
|
|
41
|
3631BB
|
METOCLOPRAMIDE 10MG TAB (FSB)
|
500'S
|
A
|
0.0437
|
10MG
|
90
|
2024-04-01
|
2026-03-31
|
|
|
|
6
|
|
|
42
|
3631BC
|
MPRANIM 10MG TAB (ANC) METOCLOPRAMIDE
|
500'S
|
A
|
0.02
|
10MG
|
90
|
2026-04-01
|
|
No
|
No
|
|
6
|
|
|
40
|
3633AG
|
METOCLOPRAMIDE 5MG/ML IV/IM INJ (MON/PHA)
|
10X2ML
|
B
|
0.60
|
5MG/ML IV/IM
|
0
|
2022-04-01
|
2024-03-31
|
|
|
|
0
|