Displaying 4061 - 4080 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 58652 VFEND 200MG INJ (PFI) VORICONAZOLE 100ML C 311.68 200MG 28 2026-04-01 No No 0
40 58654 VORIOLE 200MG INJ (MSN/ATB) VORICONAZOLE 200MG VIAL BQ 40.77 200MG 0 2022-04-01 2024-03-31 0
40 58811 GLUCOBAY 50MG TAB (BSP/COL) ACARBOSE 84'S C 0.22 50MG 0 2022-04-01 2024-03-31 0
41 58811 GLUCOBAY 50MG TAB (BSP) ACARBOSE (C) 84'S C 0.2191 50MG 180 2024-04-01 2024-07-25 6
40 58816 GLUCOBAY 50MG TAB (BSP/AHI) ACARBOSE 84'S C 0.22 50MG 0 2022-04-01 2024-03-31 0
40 5881J ACARBOSE 50MG TAB (RYV/ATB) 90'S C 0.18 50MG 180 2022-04-01 2024-03-31 6
42 5881N GLUCAR 50MG TAB (GLP) ACARBOSE (C) 100'S C 0.02 50MG 180 2026-04-01 2028-03-31 No No 6
40 58821 GLUCOBAY 100MG TAB (BSP/COL) ACARBOSE 90'S C 0.40 100MG 0 2022-04-01 2024-03-31 0
41 58821 GLUCOBAY 100MG TAB (BSP) ACARBOSE (C) 90'S C 0.3975 100MG 90 2024-04-01 2024-07-25 6
40 58824 GLUCOBAY 100MG TAB (BSP/AHI) ACARBOSE 90'S C 0.40 100MG 0 2022-04-01 2024-03-31 0
41 58824 GLUCOBAY 100MG TAB (BSP) ACARBOSE (C) 90'S C 0.3975 100MG 90 2024-04-01 2026-03-31 6
40 5882G ACARBOSE 100MG TAB (LDP/AHI) 84'S C 0.29 100MG 0 2022-04-01 2024-03-31 0
40 5921H DANAZOL 200MG TAB (CIP/AHI) 100'S C 6.46 200MG 0 2022-04-01 2022-09-30 0
42 5921L DANOGEN 200MG CAP (CIP) DANAZOL 10X10 C 2.24 200MG 30 2026-04-01 No No 6
40 59311 PROCORALAN 5MG TAB (SER/STO) IVABRADINE 28'S C 2.17 5MG 0 2022-04-06 2024-03-31 Package Size Change 0
40 59314 PROCORALAN 5MG TAB (SER/COL) IVABRADINE 28'S C 2.17 5MG 0 2022-04-13 2024-03-31 Add to Contract as Cat C 0
40 59319 PROCOROLAN 5MG TAB (SER/COL) IVABRADINE 56'S C 2.17 5MG 0 2022-04-01 2024-03-31 0
41 59319 PROCOROLAN 5MG TAB (SER) IVABRADINE (C) 56'S C 1.948 5MG 0 2024-04-01 2026-03-31 0
42 59319 PROCOROLAN 5MG TAB (SER) IVABRADINE 56'S C 1.95 5MG 0 2026-04-01 2028-03-31 No No 0
40 5931A PROCORLAN 5MG TAB (SER/STO) IVABRADINE 56'S C 2.17 5MG 0 2022-04-01 2024-03-31 0