Displaying 3321 - 3340 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 5201GN LIFESTYLE WET RIDER (ANS) CONDOM 3'S C 1.4679 0 2024-04-01 2024-07-22 0
41 5201GN LIFESTYLE WET RIDER (ANS) CONDOM 3'S C 1.72 0 2024-07-23 2026-03-31 0
42 5201GN LIFESTYLE WET RIDER (ANS) CONDOM 3'S C 1.47 0 2026-04-01 No No 0
42 5201GP LIFESTYLES EVERLAST RIDER (ANS) CONDOM 3'S C 1.47 0 2026-04-01 No No 0
42 5201GS LIFESTYLES SKYN ELITE CONDOM (ANS) CONDOM 3'S C 1.72 0 2026-04-01 No No 0
42 5201GT LIFESTYLES MIDNIGHT RIDER (ANS) CONDOM 3'S C 0.49 0 2026-04-01 No No 0
40 5201N LIFESTYLES STUDDED (ANS/SBI) CONDOM 3'S C 3.59 0 2022-04-01 2022-06-12 0
40 5201N LIFESTYLES STUDDED (ANS/SBI) CONDOM 3'S C 6.16 0 2022-06-14 2024-03-31 Price Change 0
40 5201Q LIFESTYLES BARE RIDER (ANS/SBI) CONDOM 3'S C 3.59 0 2022-04-01 0
40 5201Q LIFESTYLES BARE RIDER (ANS/SBI) CONDOM 3'S C 1.25 0 2022-06-10 2024-03-31 Price Change 0
41 5201Q LIFESTYLES BARE RIDER (ANS) CONDOM 3'S C 1.4679 0 2024-04-01 2024-07-22 0
41 5201Q LIFESTYLES BARE RIDER (ANS) CONDOM 3'S C 1.72 0 2024-07-23 2026-03-31 0
42 5201Q LIFESTYLES BARE RIDER (ANS) CONDOM 3'S C 1.47 0 2026-04-01 No No 0
40 52217 APO-BACLOFEN 10MG TAB (APO/COL) 100'S A 0.06 10MG 180 2022-04-01 2024-03-31 6
42 52217 APO-BACLOFEN 10MG TAB (APO) 100'S A 0.06 10MG 180 2026-04-01 No No 6
41 5221AB APO-BACLOFEN 10MG TAB (APO) 100'S A 0.0625 10MG 180 2024-04-01 2026-03-31 6
41 5221AC BACLOFEN 10MG TAB (FSB) 10X10 A 0.0546 10MG 180 2024-04-01 2026-03-31 6
40 5221N PMS-BACLOFEN 10MG TAB (PMS/COL) 100'S A 0.07 10MG 180 2022-04-01 2024-03-31 6
40 5231AD DAKTARIN 2% CR (JAC/STO) MICONAZOLE 30G C 15.41 2% 0 2022-04-01 2022-05-24 Delete from contract 0
40 5231AY NIZORAL 2% CR (JAC/STO) KETOCONAZOLE 40G C 22.26 2% 0 2022-04-01 2024-03-31 0