Displaying 3761 - 3780 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 5698AC ACYCLOVIR DISP 800MG TAB (HEA/ATB) (C) 1X10 C 0.7 800MG 2022-12-07 2024-03-31 No No Change Local Agent 0
41 5698AC ACYCLOVIR 800MG DISP TAB (HEA) 1X10 A 0.6986 800MG 50 2024-04-01 2026-03-31 0
40 5698L ACYCLOVIR 800MG TAB (CHC/ATB) 100'S A 0.29 800MG 50 2022-04-01 2024-03-31 0
42 5698M ACYCLOVIR 800MG DISP TAB (HEA) 1X10 B 0.69 800MG 50 2026-03-30 No No Price Change 0
41 5698P APO-ACYCLOVIR 800MG TAB (APO) 100'S A 0.3955 800MG 50 2024-04-01 2026-03-31 0
42 5698R ACYCLOVIR 800MG DISP TAB (HEA) (C) 1X10 B 0.69 800MG 50 2026-04-01 No No Add to Contract as Cat B 0
40 57514 APO-TERAZOSIN 1MG TAB (APO/COL) 100'S B 0.05 1MG 0 2022-04-01 2024-03-31 0
42 57514 APO-TERAZOSIN 1MG TAB (APO) 100'S B 0.05 1MG 60 2026-04-01 No No 6
40 5751H APO-PRAZO 1MG TAB (APO/COL) 100'S B 0.07 1MG 0 2022-04-01 2024-03-31 0
42 5751H APO-PRAZO 1MG TAB (APO) 100'S B 0.07 1MG 120 2026-04-01 No No 6
41 5751X APO-PRAZO 1MG TAB (APO) (B) 100'S B 0.068 1MG 120 2024-04-01 2026-03-31 6
41 5751Y APO-TERAZOSIN 1MG TAB (APO) (B) 100'S B 0.0495 1MG 60 2024-04-01 2026-03-31 6
40 57522 HYTRIN 2MG TAB (ABB/PHA) TERAZOSIN 28'S C 0.23 2MG 0 2022-04-01 2024-03-31 0
40 57522 HYTRIN 2MG TAB (ABB/PHA) TERAZOSIN (C) 28'S C 0.2261 2MG 2022-04-01 2023-03-31 No No Delete from contract 0
40 57526 APO-TERAZOSIN 2MG TAB (APO/COL) 100'S B 0.04 2MG 0 2022-04-01 2024-03-31 0
42 57526 APO-TERAZOSIN 2MG TAB (APO) 100'S B 0.04 2MG 60 2026-04-01 No No 6
41 5752AA HYTRIN 2MG TAB (ABB) TERAZOSIN (C) 28'S C 0.2349 2MG 60 2024-04-01 2026-03-31 6
40 5752J APO-PRAZO 2MG TAB (APO/COL) 100'S B 0.08 2MG 0 2022-04-01 2024-03-31 0
42 5752J APO-PRAZO 2MG TAB (APO) 100'S B 0.08 2MG 120 2026-04-01 No No 6
41 5752Y APO-PRAZO 2MG TAB (APO) (B) 100'S B 0.0832 2MG 120 2024-04-01 2026-03-31 6