Displaying 4361 - 4380 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 6691M ANGELIQ 2MG|1MG TAB (BSP) DROSPIRENONE|ESTRADIOL 28'S C 26.61 2MG|1MG 0 2026-04-01 No No 0
41 6691N ANGELIQ 1MG E/2MG D TAB (BSP) ESTRADIOL/ (C) 28'S C 26.6124 2MG|1MG 0 2024-04-01 2026-03-31 0
42 6691N ANGELIQ 2MG|1MG TAB (BSP) DROSPIRENONE|ESTRADIOL 28'S C 24.22 2MG|1MG 0 2026-04-01 No No 0
40 6691S PROGYNOVA 1MG TAB (BSP/COL) OESTRADIOL 28'S A 10.33 1MG 1 2022-04-01 2024-03-31 6
41 6691S PROGYNOVA 1MG TAB (BSP) OESTRADIOL 28'S A 10.3296 1MG 1 2024-04-01 2026-03-31 6
42 6691S PROGYNOVA 1MG TAB (BSP) OESTRADIOL 28'S A 10.87 1MG 1 2026-04-01 No No 6
40 6691T PROGYNOVA 2MG TAB (BSP/COL) OESTRADIOL 28'S A 11.96 2MG 1 2022-04-01 2024-03-31 6
41 6691T PROGYNOVA 2MG TAB (BSP) OESTRADIOL 28'S A 11.9606 2MG 1 2024-04-01 2026-03-31 6
42 6691T PROGYNOVA 2MG TAB (BSP) OESTRADIOL 28'S A 11.96 2MG 1 2026-04-01 No No 6
40 6711AL AVELOX 400MG TAB (BSP/COL) MOXIFLOXACIN 20'S C 9.11 400MG 0 2022-04-01 2024-03-31 0
41 6711AL AVELOX 400MG TAB (BSP) MOXIFLOXACIN (C) 20'S C 9.1064 400MG 0 2024-04-01 2026-03-31 0
41 6711BB ZINDOLIN 500MG TAB (REM) CIPROFLOXACIN (C) 10X10 C 0.1696 500MG 14 2024-04-01 2026-03-31 0
42 6711BB ZINDOLIN 500MG TAB (REM) CIPROFLOXACIN 10X10 C 0.25 500MG 14 2026-04-01 No No 0
40 6711CR ELEQUINE 500MG TAB (JAC/STO) LEVOFLOXACIN 24'S C 7.92 500MG 0 2022-04-01 2024-03-31 0
41 6711CR ELEQUINE 500MG TAB (JAC) LEVOFLOXACIN (C) 24'S C 7.9228 500MG 14 2024-04-01 2026-03-31 0
42 6711CR ELEQUINE 500MG TAB (JAC) LEVOFLOXACIN 24'S C 7.92 500MG 14 2026-04-01 No No 0
40 6711CT ELEQUINE 750MG TAB (JAC/STO) LEVOFLOXACIN 20'S C 15.07 750MG 0 2022-04-01 2024-03-31 0
41 6711CT ELEQUINE 750MG TAB (JAC) LEVOFLOXACIN (C) 20'S C 15.0731 750MG 14 2024-04-01 2026-03-31 0
42 6711CT ELEQUINE 750MG TAB (JAC) LEVOFLOXACIN 20'S C 15.07 750MG 14 2026-04-01 No No 0
40 6711CY CIPROFLOXACIN 500MG TAB (HEA/RXP) 10X10 A 0.15 500MG 14 2022-04-01 2024-03-31 0