Displaying 3521 - 3540 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 5511AE SURE COMFORT 31GX5/16'' (ALM/PHA) INSULIN S 100'S A 0.23 10 2022-04-01 2024-03-31 6
41 5511AE SURE COMFORT 31GX5/16'' (ALM) INSULIN 100'S A 0.2365 10 2024-04-01 2026-03-31 6
42 5511AE SURE COMFORT 31GX5/16'' (ALM) INSULIN 100'S A 0.20 10 2026-04-01 No No 6
40 5511AS NOVOFINE 32G (NOV/COL) PEN NEEDLES 100'S C 0.45 0 2022-04-01 2024-03-31 0
41 5511AS NOVOFINE 32G (NOV) PEN NEEDLES (C) 100'S C 0.4453 0 2024-04-01 2026-03-31 0
42 5511AS NOVOFINE 32G (NOV) PEN NEEDLES 100'S C 0.45 0 2026-04-01 No No 0
40 5511AV FORSURE INSULIN SYRINGES 31GX1\2" (CSC/PHA) 100X1ML A 0.22 10 2022-04-01 2022-07-27 Delete from contract 6
41 5511AV FORSURE INSULIN SYRINGES 31GX1\2" (CSC 100X1ML A 0.1829 10 2024-04-01 2026-03-31 6
42 5511AX ACCU-FINE 32G (PRI) PEN NEEDLES 100'S B 0.26 32G 10 2026-04-01 No No 0
40 5521BA AAP-MINOCYCLINE 100MG CAP (APO/COL) 100'S A 0.84 100MG 15 2022-04-01 2024-03-31 0
42 5521BA AAP-MINOCYCLINE 100MG CAP (APO) 100'S A 0.84 100MG 15 2026-04-01 No No 0
40 5521BV DOXYCYCLINE 100MG TAB (GPC/ATB) 100'S A 0.07 100MG 14 2022-04-01 2022-09-30 0
40 5521CJ DOXYCYCLINE 100MG TAB (FSB/ATB) 3X10 A 0.10 100MG 14 2022-04-01 2024-03-31 Add to Contract as Cat A 0
41 5521CK APO-DOXY 100MG TAB (APO) 100'S A 0.1237 100MG 14 2024-04-01 2026-03-31 0
41 5521CL AAP-MINOCYCLINE 100MG TAB (APO) 100'S A 0.84 100MG 15 2024-04-01 2026-03-31 0
42 5521E APO-DOXY 100MG CAP (APO) 100'S A 0.12 100MG 14 2026-04-01 No No 0
40 5521ZC AAP-MINOCYCLINE 50MG CAP (APO/COL) 100'S A 0.46 50MG 14 2022-04-01 2024-03-31 0
42 5521ZC AAP-MINOCYCLINE 50MG CAP (APO) 100'S A 0.47 50MG 14 2026-04-01 No No 0
40 5521ZU REMYCIN 100MG TAB (REM/SBI) DOXYCYCLINE 10X10 C 0.14 100MG 0 2022-04-01 2024-03-31 0
41 5521ZU REMYCIN 100MG TAB (REM) DOXYCYCLINE 10X10 A 0.1294 100MG 14 2024-04-01 2026-03-31 0