Displaying 2901 - 2920 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 4331AB SUTENT 12.5MG TAB (PFI/STO) SUNITINIB 28'S C 123.35 12.5MG 0 2022-04-01 2024-03-31 0
41 4331AB SUTENT 12.5MG TAB (PFI) SUNITINIB (BQ) 28'S BQ 123.3527 12.5MG 0 2024-04-01 2026-03-31 6
42 4331AB SUTENT 12.5MG CAP (PFI) SUNITINIB 28'S C 123.35 12.5MG 0 2026-04-01 No No 6
40 4331AC SUTENT 25MG TAB (PFI/STO) SUNITINIB 28'S C 242.59 25MG 0 2022-04-01 2024-03-31 0
41 4331AC SUTENT 25MG TAB (PFI) SUNITINIB (BQ) 28'S BQ 242.5929 25MG 0 2024-04-01 2026-03-31 6
42 4331AC SUTENT 25MG CAP (PFI) SUNITINIB 28'S C 242.59 25MG 0 2026-04-01 No No 6
42 4331AD IMATINIB DENK 100MG TAB (EDK) 30'S BQ 43.04 100MG 120 2026-04-01 No No 0
40 4331AN XELJANZ 5MG TAB (PFI/STO) TOFACITINIB 60'S C 39.56 5MG 0 2022-04-01 2024-03-31 0
41 4331AN XELJANZ 5MG TAB (PFI) TOFACITINIB (C) 60'S C 39.5571 5MG 0 2024-04-01 2026-03-31 0
42 4331AN XELJANZ 5MG TAB (PFI) TOFACITINIB 60'S C 39.56 5MG 0 2026-04-01 No No 0
41 4331BA APO-IMATINIB 100MG TAB (APO) IMATIN (BQ) 30'S BQ 1.1508 100MG 120 2024-04-01 2026-03-31 0
41 4331BB ZIMITIB 100MG CAP (ZUV) IMATINIB (BQ) 120'S BQ 0.5147 100MG 120 2024-04-01 2024-05-17 6
41 4331BD ZIMITIB 100 CAP (ZUV) IMATINIB 30'S BQ 1.5893 100 2024-04-05 2026-03-31
40 4331E SUTENT 50MG TAB (PFI/STO) SUNITINIB 28'S C 452.29 50MG 0 2022-04-01 2024-03-31 0
41 4331E SUTENT 50MG TAB (PFI) SUNITINIB (BQ) 28'S BQ 452.2913 50MG 0 2024-04-01 2026-03-31 6
42 4331E SUTENT 50MG CAP (PFI) SUNITINIB 28'S C 452.29 50MG 0 2026-04-01 No No 6
40 4331G TASIGNA 150MG CAP (NVS/COL) NILOTANIB 112'S C 102.60 150MG 0 2022-04-01 2024-03-31 0
41 4331G TASIGNA 150MG CAP (NVS) NILOTANIB (BQ) 112'S BQ 67.9581 150MG 0 2024-04-01 2026-03-31 0
42 4331G TASIGNA 150MG CAP (NVS) NILOTANIB 112'S C 67.96 150MG 0 2026-04-01 No No 0
40 4331L AFINITOR 5MG TAB (NVS/COL) EVEROLIMUS 30'S C 181.22 5MG 0 2022-04-01 2024-03-31 0