Displaying 2541 - 2560 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
40 39634 EPILIM CHRONO 199.8MG | 87MG TAB (SFA/COL) SODI 30'S A 0.50 199.8MG|87MG 150 2022-04-01 2024-03-31 6
40 39635 VALEX 199.8MG|87MG CR TAB(INC) SODIUM VALPROATE|VALPROIC AC 30 A 0.406 199.8MG|87MG 150 0000-00-00 0000-00-00 6
41 39635 VALEX 199.8MG|87MG CR TAB (INC) SODIUM VALPROATE|VALPROIC AC 3X10 A 0.4387 199.8MG|87MG 90 2024-04-01 2026-03-31 6
42 39639 LEEPORATE CHRONO 199.8MG|87MG CR TAB (JLP) SODIUM VALPROATE| 10X10 A 0.14 199.8MG|87MG 150 2026-04-01 No No 6
42 3963A VALSONIM 199.8MG|87MG CR TAB (ANC) SODIUM VALPROATE|VALPROIC 100'S A 0.11 199.8MG|87MG 150 2026-04-01 No No Add to Contract as Cat A 6
41 39648 SODIUM VALPROATE 100MG/ML INJ (DIL) (B) 10X5ML B 14.2658 100MG/ML 0 2024-04-01 2026-03-31 0
40 39654 DEPAKOTE ER 500MG TAB (ABB/PHA) VALPROIC ACID 100'S A 0.71 500MG 120 2022-04-01 2024-03-31 6
40 39654 DEPAKOTE ER 500MG TAB (ABB/PHA) VALPROIC ACID 100'S A 0.7136 500MG 2022-04-01 2023-03-31 No No Delete from contract 6
40 39659 DEPAKOTE 500MG TAB (ABB/PHA) VALPROIC ACID 30'S A 1.52 500MG 120 2022-04-01 2024-03-31 6
40 39659 DEPAKOTE 500MG TAB (ABB/PHA) VALPROIC ACID 30'S A 1.5223 500MG 2022-04-01 2023-03-31 No No Delete from contract 6
40 3965A EPILIM CHRONO 333MG | 145M TAB (SFA/COL) SODIUM VALPROATE | VALPROIC ACID 30'S A 0.65 333MG|145MG 150 2022-04-01 2024-03-31 6
41 3965A EPILIM CHRONO 333MG|145MG CR TAB (SFA) SODIUM VALPROATE|VALP 30'S A 0.6515 333MG|145MG 120 2024-04-01 2026-03-31 6
40 3965C DEPAKOTE 500MG TAB (ABB) SODIUM VALPROIC 30 A 1.521 500MG 90 0000-00-00 0000-00-00 CHANGE OF DISTRIBUTOR 6
41 3965C DEPAKOTE 500MG TAB (ABB) VALPROIC ACID 30'S A 1.5948 500MG 120 2024-04-01 2026-03-31 6
42 3965C DEPAKOTE 500MG TAB (ABB) VALPROIC ACID 30'S A 1.45 500MG 120 2026-04-01 No No 6
41 3965D DEPAKOTE 500MG ER TAB (ABB) VALPROIC ACID 30'S A 0.897 500MG 150 2024-04-01 2026-03-31 6
42 3965G VALSONIM 500MG TAB (ANC) VALPROIC ACID 100'S A 0.19 333MG|145MG 120 2026-04-01 No No Price Change 6
42 3965L LEEPORATE CHRONO 333MG|145MG CR TAB (JLP) SODIUM VALPROATE|V 10X10 A 0.15 333MG|145MG 120 2026-04-01 No No 6
40 4021C AZITHROMYCIN 500MG INJ (DIL/AHI) 10X500MG BQ 40.38 500MG 0 2022-04-01 2022-09-30 0
40 4021E ERYTHROMYCIN 500MG INJ (CIR/AHI) 500MG VIAL BQ 28.92 500MG 0 2022-04-01 2024-03-31 6