|
|
42
|
39216
|
PLAVIX 75MG TAB (SFA) CLOPIDOGREL
|
28'S
|
C
|
2.91
|
75MG
|
30
|
2026-04-01
|
|
No
|
No
|
|
6
|
|
|
40
|
3921BS
|
CLOPIDOGREL 75MG TAB (KWA/ATB)
|
100'S
|
A
|
0.08
|
75MG
|
30
|
2022-04-01
|
2024-03-31
|
|
|
|
6
|
|
|
40
|
3921CH
|
BRILINTA 90MG TAB (AZN/COL) TICAGRELOR
|
60'S
|
C
|
2.04
|
90MG
|
0
|
2022-04-01
|
2024-03-31
|
|
|
|
0
|
|
|
41
|
3921CH
|
BRILINTA 90MG TAB (AZN) TICAGRELOR (C)
|
60'S
|
C
|
2.0387
|
90MG
|
60
|
2024-04-01
|
2026-03-31
|
|
|
|
0
|
|
|
42
|
3921CH
|
BRILINTA 90MG TAB (AZN) TICAGRELOR
|
60'S
|
C
|
2.03
|
90MG
|
60
|
2026-04-01
|
|
No
|
No
|
|
0
|
|
|
40
|
3921CK
|
PLASEP 75MG TAB (MSN/ATB) CLOPIDOGREL
|
3X10
|
A
|
0.06
|
75MG
|
30
|
2022-04-01
|
2022-07-26
|
|
|
|
6
|
|
|
40
|
3921CK
|
PLASEP 75MG TAB (MSN/ATB) CLOPIDOGREL
|
3X10
|
A
|
0.07
|
75MG
|
30
|
2022-09-06
|
2024-03-31
|
|
|
Price Change
|
6
|
|
|
41
|
3921CK
|
PLASEP 75MG TAB (MSN) CLOPIDOGREL
|
3X10
|
A
|
0.0879
|
75MG
|
30
|
2024-04-01
|
2026-03-31
|
|
|
|
6
|
|
|
40
|
3921CM
|
DIPYRIDAMOLE 50MG TAB (LDP/AHI)
|
100'S
|
BQ
|
0.50
|
50MG
|
120
|
2022-04-01
|
2024-03-31
|
|
|
Add to Contract as Cat B
|
6
|
|
|
40
|
3921CQ
|
DIPYRIDAMOLE 25MG TAB (LDP/AHI)
|
100'S
|
BQ
|
0.50
|
25MG
|
120
|
2022-04-01
|
2024-03-31
|
|
|
Add to Contract as Cat B
|
6
|
|
|
40
|
3921CS
|
DIPYRIDAMOLE 75MG TAB (LDP/AHI)
|
100'S
|
BQ
|
0.50
|
75MG
|
120
|
2022-04-01
|
2024-03-31
|
|
|
Add to Contract as Cat B
|
6
|
|
|
41
|
3921DM
|
CLOPIDOGREL 75MG TAB (MCP)
|
10X10
|
A
|
0.0693
|
75MG
|
30
|
2024-04-01
|
2026-03-31
|
|
|
|
6
|
|
|
42
|
3921EA
|
BRIREM 90MG TAB (REM) TICAGRELOR
|
14X4
|
B
|
0.49
|
90MG
|
60
|
2026-04-01
|
|
No
|
No
|
|
0
|
|
|
42
|
3921ER
|
PLASEP 75MG TAB (MSN) CLOPIDOGREL
|
3X10
|
A
|
0.08
|
75MG
|
30
|
2026-04-01
|
|
No
|
No
|
Add to Contract as Cat A
|
6
|
|
|
40
|
3921K
|
ANTIPLAR 75MG TAB (EMC/COL) CLOPIDOGREL
|
100'S
|
A
|
0.10
|
75MG
|
30
|
2022-05-31
|
2022-12-31
|
|
|
|
6
|
|
|
41
|
3921K
|
ANTIPLAR 75MG TAB (EMC) CLOPIDOGREL
|
100'S
|
A
|
0.087
|
75MG
|
30
|
2024-04-01
|
2026-03-31
|
|
|
|
6
|
|
|
42
|
3921K
|
ANTIPLAR 75MG TAB (EMC) CLOPIDOGREL
|
100'S
|
A
|
0.09
|
75MG
|
30
|
2026-04-01
|
|
No
|
No
|
|
6
|
|
|
42
|
39612
|
APO-VALPROIC 250MG CAP (APO)
|
100'S
|
A
|
0.38
|
250MG
|
90
|
2026-04-01
|
|
No
|
No
|
|
6
|
|
|
40
|
3961AD
|
DEPAKOTE ER 250MG TAB (ABB/PHA) VALPROIC ACID
|
100'S
|
A
|
0.71
|
250MG
|
90
|
2022-04-01
|
2024-03-31
|
|
|
|
6
|
|
|
40
|
3961AD
|
DEPAKOTE ER 250MG TAB (ABB/PHA) VALPROIC ACID
|
100'S
|
A
|
0.7136
|
250MG
|
|
2022-04-01
|
2023-03-31
|
No
|
No
|
Delete from contract
|
6
|
