Displaying 4081 - 4100 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
41 5931A PROCORLAN 5MG TAB (SER) IVABRADINE (C) 56'S C 1.948 5MG 0 2024-04-01 2026-03-31 0
42 5931A PROCOROLAN 5MG TAB (SER) IVABRADINE 56'S C 1.95 5MG 0 2026-04-01 No No 0
40 5931B IVABRADINE 5MG TAB (INP/AHI) 56'S BQ 0.99 5MG 0 2022-04-01 2024-03-31 6
41 5931C BRADIREM 5MG TAB (REM) IVABRADINE (BQ) 56'S BQ 0.3291 5MG 0 2024-04-01 2026-03-31 0
42 5931C BRADIREM 5MG TAB (REM) IVABRADINE 56'S B 0.34 5MG 0 2026-04-01 No No 0
40 59321 PROCORALAN 7.5MG TAB (SER/STO) IVABRADINE 28'S C 2.17 7.5MG 0 2022-04-01 2024-03-31 Package Size Change 0
40 59323 PROCORALAN 7.5MG TAB (SER/COL) IVABRADINE 28'S C 2.17 7.5MG 0 2022-04-13 2024-03-31 Add to Contract as Cat C 0
40 59326 PROCOROLAN 7.5MG TAB (SER/COL) IVABRADINE 56'S C 2.17 7.5MG 0 2022-04-01 2024-03-31 0
41 59326 PROCOROLAN 7.5MG TAB (SER) IVABRADI (C) 56'S C 1.948 7.5MG 0 2024-04-01 2026-03-31 0
42 59326 PROCOROLAN 7.5MG TAB (SER) IVABRADI 56'S C 1.95 7.5MG 0 2026-04-01 No No 0
40 59327 PROCORLAN 7.5MG TAB (SER/STO) IVABRADINE 56'S C 2.17 7.5MG 0 2022-04-01 2024-03-31 0
41 59327 PROCORLAN 7.5MG TAB (SER) IVABRADIN (C) 56'S C 1.948 7.5MG 0 2024-04-01 2026-03-31 0
42 59327 PROCOROLAN 7.5MG TAB (SER) IVABRADIN 56'S C 1.95 7.5MG 0 2026-04-01 No No 0
40 59328 IVABRADINE 7.5MG TAB (INP/AHI) 56'S BQ 1.10 7.5MG 0 2022-04-01 2024-03-31 6
41 59329 BRADIREM 7.5MG TAB (REM) IVABRADINE (BQ) 56'S BQ 0.4738 7.5MG 0 2024-04-01 2026-03-31 0
42 59329 BRADIREM 7.5MG TAB (REM) IVABRADINE 56'S B 0.87 7.5MG 0 2026-04-01 No No 0
40 59511 PRED-FORTE 1% EYE DR (ALL/COL) PREDNISOLONE 5ML C 17.67 1% 0 2022-04-01 2024-03-31 0
41 59511 PRED-FORTE 1% EYE DR (ALL) PREDNISOLONE (C) 5ML C 17.6691 1% 1 2024-04-01 2026-03-31 6
42 59511 PRED-FORTE 1% EYE DR (ALL) PREDNISOLONE 5ML C 17.67 1% 1 2026-04-01 No No 6
40 59519 PREDNISOLONE 1% EYE DR (CIR/AHI) 5ML A 6.22 1% 1 2022-04-01 2024-03-31 6