Displaying 4261 - 4280 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 65712 CLOZAPINE 25MG TAB (APL) 100'S BP 1.2295 25MG 270 2024-04-01 2026-03-31 6
40 65715 SKIZORIL 25MG TAB (INP/AAL) CLOZAPINE 500'S BP 0.18 25MG 0 2022-04-01 2024-03-31 6
42 65717 PSYLOPINE 25MG TAB (JLP) CLOZAPINE 10X10 A 0.20 25MG 270 2026-04-01 No No 6
40 65726 CLOZAREM 100MG TAB (REM/SBI) CLOZAPINE 5X10 B 0.51 100MG 0 2022-04-01 2024-03-31 0
41 65726 CLOZAREM 100MG TAB (REM) CLOZAPINE 5X10 BP 0.4871 100MG 270 2024-04-01 2026-03-31 9
42 65726 CLOZAREM 100MG TAB (REM) CLOZAPINE 5X10 A 0.49 100MG 168 2026-04-01 No No 6
40 65811 LECTRUM 11.25MG INJ (BCH/COL) LEUPROLIDE KIT C 462.31 11.25MG 0 2022-04-01 2024-03-31 0
41 65811 LECTRUM 11.25MG INJ (BCH) LEUPROLIDE (BQ) KIT BQ 462.3054 11.25MG 0 2024-04-01 2026-03-31 0
42 65811 LECTRUM 11.25MG INJ (BCH) LEUPROLIDE KIT BQ 466.87 11.25MG 0 2026-04-01 No No 0
40 6581C LECTRUM 3.75MG INJ (BCH/COL) LEUPROLIDE 3.75MG KIT BQ 173.97 3.75MG 0 2022-04-01 2024-03-31 0
41 6581C LECTRUM 3.75MG INJ (BCH) LEUPROLIDE (BQ) 3.75MG KIT BQ 173.9727 3.75MG 0 2024-04-01 2026-03-31 0
42 6581C LECTRUM 3.75MG INJ (BCH) LEUPROLIDE 3.75MG KIT BQ 173.97 3.75MG 0 2026-04-01 No No 0
40 6581D LECTRUM 7.5MG INJ (BCH/COL) LEUPROLIDE 7.5MG KIT C 369.04 7.5MG 0 2022-04-01 2024-03-31 0
41 6581D LECTRUM 7.5MG INJ (BCH) LEUPROLIDE (C) 7.5MG KIT C 369.0397 7.5MG 0 2024-04-01 2026-03-31 0
42 6581D LECTRUM 7.5MG INJ (BCH) LEUPROLIDE 7.5MG KIT C 369.04 7.5MG 0 2026-04-01 No No 0
40 6581R ZOLADEX 10.8MG KIT (AZN/COL) GOSERELIN 10.8MG KIT C 611.62 10.8MG 0 2022-04-01 2024-03-31 0
41 6581R ZOLADEX 10.8MG KIT (AZN) GOSERELIN (C) 10.8MG KIT C 611.6229 10.8MG 0 2024-04-01 2026-03-31 0
42 6581R ZOLADEX 10.8MG KIT (AZN) GOSERELIN 10.8MG KIT BQ 611.62 10.8MG 0 2026-04-01 No No 0
40 6581S ZOLADEX 3.6MG KIT (AZN/COL) GOSERELIN 3.6MG KIT C 205.51 3.6MG 0 2022-04-01 2024-03-31 0
41 6581S ZOLADEX 3.6MG KIT (AZN) GOSERELIN (C) 3.6MG KIT C 205.5053 3.6MG 0 2024-04-01 2026-03-31 0