Displaying 3741 - 3760 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 56956 OPTIVIRAL 3% EYE OINT (SPC) ACYCLOVIR 5G A 2.36 3% 2 2026-04-01 No No 0
40 56965 APO-ACYCLOVIR 400MG TAB (APO/COL) 100'S A 0.30 400MG 50 2022-04-01 2024-03-31 0
42 56965 APO-ACYCLOVIR 400MG TAB (APO) 100'S A 0.31 400MG 50 2026-04-01 No No 0
40 56968 ACYCLOVIR DISP 400MG TAB (HEA/RXP) 1X10 A 0.37 400MG 50 2022-04-01 2024-03-31 0
42 5696AA ACYCLOVIR 400MG DISP TAB (HEA) 1X10 A 0.39 400MG 50 2026-04-01 No No Add to Contract as Cat A 0
40 5696AB ACYCLOVIR DISP 400MG TAB (HEA/ATB) 1X10 A 0.367 400MG 2022-12-07 2024-03-31 No No Change Local Agent 0
41 5696AB ACYCLOVIR DISP 400MG TAB (HEA) 1X10 A 0.4023 400MG 50 2024-04-01 2026-03-31 0
42 5696AH ACYCLOVIR 400MG DISP TAB (HEA) 1X10 A 0.39 400MG 50 2026-04-01 No No Add to Contract as Cat A 0
42 5696W ACYCLOVIR 400MG DISP TAB (HEA) 1X10 A 0.39 400MG 50 2026-04-01 No No Price Change 0
40 56975 ZOVIRAX 40MG/ML SUSP (GSK/COL) ACYCLOVIR 125ML B 0.62 40MG/ML 0 2022-04-01 2024-03-31 6
41 5697E ACYCLOVIR 40MG/ML SUSP (WAT) (B) 473ML B 1.2555 40MG/ML 10 2024-04-01 2026-03-31 0
42 5697G ACICLOVIR 40MG/ML SUSP (CIR) ACYCLOVIR 100ML A 0.08 40MG/ML 100 2026-04-01 No No 0
40 56985 APO-ACYCLOVIR 800MG TAB (APO/COL) 100'S A 0.39 800MG 50 2022-04-01 2024-03-31 0
42 56985 APO-ACYCLOVIR 800MG TAB (APO) 100'S A 0.40 800MG 50 2026-04-01 No No 0
40 56988 CYCLOVAX 800MG TAB (REM/SBI) ACYCLOVIR 1x10 C 0.41 800MG 0 2022-04-01 2024-03-31 0
41 56988 CYCLOVAX 800MG TAB (REM) ACYCLOVIR 1x10 A 0.6497 800MG 50 2024-04-01 2026-03-31 0
42 56988 CYCLOVAX 800MG TAB (REM) ACYCLOVIR (C) 1x10 C 0.68 800MG 50 2026-04-01 No No 0
40 5698A ACYCLOVIR DISP 800MG TAB (HEA/RXP) 1X10 C 0.65 800MG 0 2022-04-01 2024-03-31 0
42 5698AA ACYCLOVIR 800MG DISP TAB (HEA) 1X10 B 0.69 800MG 50 2026-04-01 No No Add to Contract as Cat B 0
40 5698AC ACYCLOVIR DISP 800MG TAB (HEA/ATB) (C) 1X10 C 0.7 800MG 0 2022-07-12 No No la 0