Displaying 3421 - 3440 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 5233C CANDID 1% PWDR (GLP) CLOTRIMAZOLE 100G A 5.44 1% 1 2026-04-01 No No 0
42 5233E CLOTRIFOX 1% PWDR (JLP) CLOTRIMAZOLE 100G A 5.44 1% 1 2026-04-01 No No 0
40 5233Q MICOSPEC 2% PWDR (CAR/COL) MICONAZOLE 15G A 4.89 2% 2 2022-04-01 2024-03-31 0
41 5233Q MICOSPEC 2% POWDER (CAR) MICONAZOLE 15G A 5.1104 2% 2 2024-04-01 2026-03-31 0
42 5233Q MICOSPEC 2% POWDER (CAR) MICONAZOLE 15G A 5.11 2% 2 2026-04-01 No No 0
40 52352 DAKTARIN 2% GEL (JAC/STO) MICONAZOLE 78G BQ 28.27 2% 0 2022-04-01 2022-05-24 Delete from contract 0
41 52353 MICOGEL ORAL 2% GEL (CIP) MICONAZOLE 15G B 5.3551 2% 2 2024-04-01 2026-03-31 6
41 52354 MICOGEL 2% GEL (ARP) MICONAZOLE 15G B 5.36 2% 2 2024-04-01 2026-03-31 6
42 52354 MICOGEL ORAL 2% GEL (ARP) MICONAZOLE 15G B 4.65 2% 2 2026-04-01 No No 6
40 52424 TRIVASTAL RETARD 50MG TAB (SER/STO) PIRIBEDIL 30'S C 0.78 50MG 0 2022-04-01 2024-03-31 0
41 52424 TRIVASTAL RETARD 50MG TAB (SER) PIRIBEDIL (C) 30'S C 0.878 50MG 30 2024-04-01 2026-03-31 60
40 5242H TRIVASTAL RETARD 50MG TAB (SER/COL) PIRIBEDIL 30'S C 0.78 50MG 0 2022-04-01 2024-03-31 0
41 5242H TRIVASTAL RETARD 50MG TAB (SER) PIRIBEDIL (C) 30'S C 0.878 50MG 30 2024-04-01 2026-03-31 60
40 52614 ONE-ALPHA 0.25MCG CAP (LEO/COL) ALFACALCIDOL 100'S A 0.42 0.25MCG 120 2022-04-01 2024-03-31 6
42 5261AC CALTROL 0.25MCG CAP (JLP) CALCITRIOL 100'S A 0.18 0.25MCG 120 2026-04-01 No No 6
42 5261AD CANJOCAL 0.25MCG CAP (JLP) ALFACALCIDOL 100'S A 0.14 0.25MCG 120 2026-04-01 No No 6
40 5261W CALCITRIOL 0.25MCG CAP (FSB/ATB) 100'S A 0.16 0.25MCG 120 2022-04-01 2024-03-31 6
41 5261Y CALCITRIOL 0.25MCG CAP (KWA) 100'S A 0.1386 0.25MCG 120 2024-04-01 2026-03-31 6
41 5261Z CALCITRIOL 0.25MCG CAP (MCP) 5X10 A 0.2848 0.25MCG 120 2024-04-01 2026-03-31 6
40 52716 APO-PREGABALIN 50MG CAP (APO/COL) 100'S B 0.15 50MG 0 2022-04-01 2024-03-31 6