Displaying 2721 - 2740 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 4144V VOLTAREN SR 75MG TAB (NVS) DICLOFENAC SO (C) 20'S C 1.3863 75MG 0 2024-04-01 2026-03-31 6
42 4144V VOLTAREN 75MG SR TAB (NVS) DICLOFENAC SODIUM 20'S C 1.39 75MG 28 2026-04-01 No No 6
40 41458 ACULAR LS 0.4% EYE DR (ALL/COL) KETOROLAC 5ML C 26.64 0.4% 0 2022-04-01 2024-03-31 0
41 41458 ACULAR LS 0.4% EYE DR (ALL) KETOROLAC (C) 5ML C 26.6396 0.4% 0 2024-04-01 2026-03-31 0
42 41458 ACULAR LS 0.4% EYE DR (ALL) KETOROLAC 5ML C 26.64 0.4% 0 2026-04-01 No No 0
40 4145AB NEVANAC 0.1% EYE DR (NVS/COL) NEPAFENAC 5ML C 16.55 0.1% 0 2022-04-01 2024-03-31 0
41 4145AB NEVANAC 0.1% EYE DR (NVS) NEPAFENAC (C) 5ML C 16.5546 0.1% 1 2024-04-01 2026-03-31 3
42 4145AB NEVANAC 0.1% EYE DR (NVS) NEPAFENAC 5ML C 16.55 0.1% 1 2026-04-01 No No 3
40 4145AE NEPAFENAC 0.1% EYE DR (CIR/AHI) 5ML A 7.48 0.1% 1 2022-04-01 2024-03-31 3
40 4145AF DICLOFENAC SOD 0.1% EYE DR (FSB/ATB) DICLOFEN 5ML A 5.30 0.1% 1 2022-04-01 2024-03-31 6
41 4145AF DICLOFENAC SODIUM 0.1% EYE DR (FSB) 5ML A 3.0445 0.1% 1 2024-04-01 2026-03-31 6
41 4145AG NEPATOP FREE 0.1% EYE DR (SYP) NEPAFENAC 5ML A 8.9161 0.1% 1 2024-04-01 2026-03-31 3
42 4145AG NEPATOP FREE 0.1% EYE DR (SYP) NEPAFENAC 5ML A 9.11 0.1% 1 2026-04-01 No No 3
42 4145AJ DICLOFENAC SODIUM 0.1% EYE DR (FSB) 5ML A 2.75 0.1% 1 2026-04-01 No No Add to Contract as Cat A 6
40 41514 PARLODEL 2.5MG TAB (BCH/COL) BROMOCRIPTINE 30'S C 0.66 2.5MG 0 2022-04-01 2024-03-31 0
40 41519 AAP-BROMOCRIPTINE 2.5MG TAB (APO/COL) 100'S C 0.44 2.5MG 0 2022-04-01 2024-03-31 Name Change 0
42 41519 AAP-BROMOCRIPTINE 2.5MG TAB (APO) 100'S A 0.45 2.5MG 90 2026-04-01 No No 6
40 4151H BROMOCRIPTINE 2.5MG TAB (KWA/ATB) 10X10 A 0.29 2.5MG 90 2022-04-01 2024-03-31 6
41 4151J AAP-BROMOCRIPTINE 2.5MG TAB (APO) (C) 100'S C 0.4518 2.5MG 90 2024-04-01 2026-03-31 6
41 4151K BROMOCRIPTINE 2.5MG TAB (KWA) 30'S A 0.2773 2.5MG 90 2024-04-01 2026-03-31 6