Displaying 2921 - 2940 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 4331L AFINITOR 5MG TAB (NVS) EVEROLIMUS (C) 30'S C 172.1605 5MG 0 2024-04-01 2026-03-31 0
42 4331L AFINITOR 5MG TAB (NVS) EVEROLIMUS 30'S C 181.22 5MG 0 2026-04-01 No No 0
40 4331M AFINITOR 10MG TAB (NVS/COL) EVEROLIMUS 30'S C 516.34 10MG 0 2022-04-01 2024-03-31 0
41 4331M AFINITOR 10MG TAB (NVS) EVEROLIMUS (C) 30'S C 344.321 10MG 0 2024-04-01 2026-03-31 0
42 4331M AFINITOR 10MG TAB (NVS) EVEROLIMUS 30'S C 362.44 10MG 0 2026-04-01 No No 0
40 43321 GLIVEC 400MG CAP (NVS/COL) IMATINIB 30'S C 153.31 400MG 0 2022-04-01 2024-03-31 0
41 43321 GLIVEC 400MG CAP (NVS) IMATINIB (SAD) (BQ) 30'S BQ 152.2914 400MG 60 2024-04-01 2026-03-31 6
42 43321 GLIVEC 400MG CAP (NVS) IMATINIB (SAD) 30'S C 152.29 400MG 60 2026-04-01 No No 6
42 43327 IMATINIB 400MG CAP (ZUV) 30'S BQ 1.07 400MG 60 2026-04-01 No No 0
40 4332B TASIGNA 200MG CAP (NVS/COL) NILOTANIB 112'S C 118.16 200MG 0 2022-04-01 2024-03-31 0
41 4332B TASIGNA 200MG CAP (NVS) NILOTANIB (BQ) 112'S BQ 92.2288 200MG 0 2024-04-01 2026-03-31 0
42 4332B TASIGNA 200MG CAP (NVS) NILOTANIB 112'S C 92.23 200MG 0 2026-04-01 No No 0
40 4332K APO-IMATINIB 400MG TAB (APO/COL) 30'S BQ 4.13 400MG 0 2022-04-01 2024-03-31 6
41 4332U TYKONIB 400MG TAB (MSN) (BQ) 30'S BQ 3.9008 400MG 60 2024-04-01 2026-03-31 6
41 4332Y APO-IMATINIB 400MG CAP (APO) (BQ) 30'S BQ 4.1735 400MG 60 2024-04-01 2026-03-31 6
40 43519 BOTTLE, GLASS RX, 30ML AMBER EACH (BEA/COL) 130'S B 0.33 0 2022-04-01 2024-03-31 0
42 4351E BOTTLE, GLASS RX, 30ML AMBER 30ML (BEA) BOTTLES 110'S B 0.36 30ML 0 2026-04-01 No No 0
40 43528 BOTTLE, GLASS RX, 60ML AMBER EACH (BEA/COL) 132'S B 0.40 0 2022-04-01 2024-03-31 Price Change 0
41 43528 BOTTLE, GLASS RX, 60ML AMBER EACH (BEA) 132'S B 0.3985 4 2024-04-01 2025-01-28 0
41 4352A BOTTLE, GLASS RX, 60ML AMBER (BEA) BOTTLES 81'S B 0.3985 4 2024-12-17 2026-03-31