Displaying 3021 - 3040 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
42 4463F YASNAL Q 5MG TAB (KRK) DONEPEZIL 28'S C 1.07 5MG 30 2026-04-01 No No 6
41 4463G RIVASTIGMINE 4.5MG CAP (KWA) (C) 60'S C 1.6636 4.5MG 30 2024-04-01 2026-03-31 0
40 4463J RIVASTIGMINE 4.5MG TAB (DRL/AHI) 60'S C 1.61 4.5MG 0 2022-04-01 2024-03-31 0
40 4463M DONEPEZIL 5MG TAB (JUB/AHI) 90'S A 0.29 5MG 30 2022-04-01 2024-03-31 deleted from Contract 6
40 4463M DONEPEZIL 5MG TAB (JUB/AHI) 90'S A 0.29 5MG 30 2022-04-01 2024-03-31 deleted from Contract 6
40 4463N DONEPEZIL 5MG TAB (CIP/AHI) 4X7'S A 0.2875 5MG 30 2022-11-29 2024-03-31 No No Add to Contract as Cat A 6
42 4463W DONEMAX 5MG TAB (JLP) DONEPEZIL 10X10 A 0.21 5MG 30 2026-04-01 No No 6
40 44642 ARICEPT 10MG TAB (PFI/STO) DONEPEZIL 28'S C 5.16 10MG 0 2022-04-01 2024-03-31 0
41 44642 ARICEPT 10MG TAB (PFI) DONEPEZIL (C) 28'S C 4.5911 10MG 30 2024-04-01 2026-03-31 6
42 44642 ARICEPT 10MG TAB (PFI) DONEPEZIL 28'S C 4.59 10MG 30 2026-04-01 No No 6
40 4464A APO-DONEPEZIL 10MG TAB (APO/COL) DONEPEZIL 100'S A 0.95 10MG 30 2022-04-01 2024-03-31 6
40 4464E YASNAL Q DISP 10MG TAB (KRK/AHI) DONEPEZIL 28'S C 1.70 10MG 0 2022-04-01 0
40 4464E YASNAL Q DISP 10MG TAB (KRK/AHI) DONEPEZIL 28'S A 1.70 10MG 30 2022-06-17 2022-09-30 6
41 4464E YASNAL Q 10MG DISP TAB (KRK) DONEPEZIL (C) 28'S C 1.699 10MG 0 2024-04-01 2026-03-31 6
42 4464E YASNAL Q 10MG DISP TAB (KRK) DONEPEZIL 28'S C 1.70 10MG 0 2026-04-01 No No 0
40 4464K RIVASTIGMINE 6MG CAP (DRL/AHI) 60'S C 1.79 6MG 0 2022-04-01 2024-03-31 0
41 4464P PMS-DONEPEZIL 10MG TAB (PMS) 100'S A 0.5301 10MG 30 2024-04-01 2026-03-31 6
42 4464P PMS-DONEPEZIL 10MG TAB (PMS) 100'S A 0.41 10MG 30 2026-04-01 No No 6
42 4464S DONEMAX 10MG TAB (JLP) DONEPEZIL 10X10 A 0.24 10MG 30 2026-04-01 No No 6
40 4582A BERIATE 500IU INJ (CSL/AHI) FACTOR VIII 10ML VIAL BQ 244.65 500IU 0 2022-04-01 2024-03-31 0