Displaying 4341 - 4360 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 6691AD QLAIRA TAB (BSP) ESTRADIOL/DIENOGEST (C) 28'S C 0.9708 3MG|3MG 0 2024-04-01 2026-03-31 0
42 6691AD QLAIRA 3MG|3MG TAB (BSP) DIENOGEST (C) 28'S C 0.82 3MG|3MG 0 2026-04-01 No No 0
40 6691AE QLAIRA TAB (BSP/AHI) ESTRADIOL/DIENOGEST 28'S C 0.97 3MG|3MG 0 2022-04-01 2024-03-31 0
41 6691AE QLAIRA TAB (BSP) ESTRADIOL/DIENOGEST (C) 28'S C 0.9708 3MG|3MG 0 2024-04-01 2026-03-31 0
42 6691AE QLAIRA 3MG|3MG TAB (BSP) DIENOGEST|ESTRADIOL 28'S C 0.90 3MG|3MG 0 2026-04-01 No No 0
40 6691AF BILIVE 1MG E/2MG D TAB (ABB/PHA) ESTRADIOL/DR 30'S C 1.00 2MG|1MG 0 2022-04-01 2024-03-31 0
40 6691AF BILIVE 1MG E/2MG D TAB (ABB/PHA) ESTRADIOL/DR (C) 30'S C 0.9993 2MG|1MG 2022-04-01 2023-04-13 No No Delete from contract 0
40 6691AH ESTROTAB 2MG TAB (ABB/PHA) OESTRADIOL 30'S C 12.91 2MG 0 2022-04-01 2024-03-31 0
40 6691AH ESTROTAB 2MG TAB (ABB/PHA) OESTRADIOL (C) 30'S C 12.91 2MG 2022-04-01 2023-03-31 No No Delete from contract 0
40 6691AJ ESTROTAB 1MG PACK (ABB/PHA) OESTRADIOL 30'S C 10.33 1MG 0 2022-04-01 2024-03-31 0
40 6691AJ ESTROTAB 1MG PACK (ABB/PHA) OESTRADIOL (C) 30'S C 10.33 1MG 2022-04-01 2023-03-31 No No Change Local Agent 0
41 6691AK VISANNE 2MG TAB (BSP) DIENOGEST (C) 28'S C 3.8833 2MG 0 2024-04-01 2026-03-31 6
42 6691AK VISANNE 2MG TAB (BSP) DIENOGEST 28'S C 3.30 2MG 0 2026-04-01 No No 0
41 6691AL VISANNE 2MG TAB (BSP) DIENOGEST (C) 28'S C 3.8833 2MG 0 2024-04-01 2026-03-31 0
42 6691AL VISANNE 2MG TAB (BSP) DIENOGEST 28'S C 3.00 2MG 0 2026-04-01 No No 0
40 6691K PROGYNOVA 1MG TAB (BSP/AHI) OESTRADIOL 28'S A 10.33 1MG 1 2022-04-01 2024-03-31 6
41 6691K PROGYNOVA 1MG TAB (BSP) OESTRADIOL 28'S A 10.3296 1MG 1 2024-04-01 2026-03-31 6
40 6691L PROGYNOVA 2MG TAB (BSP/AHI) OESTRADIOL 28'S A 11.96 2MG 1 2022-04-01 2024-03-31 6
41 6691L PROGYNOVA 2MG TAB (BSP) OESTRADIOL 28'S A 11.9606 2MG 1 2024-04-01 2026-03-31 6
41 6691M ANGELIQ 1MG E/2MG D TAB (BSP) ESTRADIOL/ (C) 28'S C 26.6124 2MG|1MG 0 2024-04-01 2026-03-31 0