Displaying 4561 - 4580 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 72416 MANGANESE 0.1 MG/ML INJ (KWA) 10ML BQ 73.2045 0.1 MG/ML 0 2024-04-01 2026-03-31 0
40 72517 COPPER 0.4 MG/ML INJ (KWA/ATB) 10ML BQ 38.06 0.4 MG/ML 0 2022-04-01 2024-03-31 0
40 72712 CHROMIUM 4 MCG/ML INJ (KWA/ATB) 10ML BQ 212.03 4MCG/ML 0 2022-04-01 2024-03-31 0
41 72712 CHROMIUM 4 MCG/ML INJ (KWA) 10ML BQ 180.2249 4MCG/ML 30 2024-04-01 2026-03-31 6
42 72713 CHROMIUM 4MCG/ML INJ (KWA) 10ML BQ 459.75 4MCG/ML 0 2026-04-01 No No Add to Contract 0
40 72811 TOPAMAX 25MG TAB (JAC/STO) TOPIRAMATE 20'S C 0.91 25MG 0 2022-04-01 2024-03-31 0
41 72811 TOPAMAX 25MG TAB (JAC) TOPIRAMATE (C) 20'S C 0.9093 25MG 60 2024-04-01 2026-03-31 6
42 72811 TOPAMAX 25MG TAB (JAC) TOPIRAMATE 20'S C 0.91 25MG 60 2026-04-01 No No 6
40 72812 APO-TOPIRAMATE 25MG TAB (APO/COL) 100'S BP 0.09 25MG 0 2022-04-01 2024-03-31 0
42 72812 APO-TOPIRAMATE 25MG TAB (APO) 100'S B 0.08 25MG 60 2026-04-01 No No 6
40 7281K NEUROTOPREL 25MG TAB (ABB/PHA) TOPIRAMATE 30'S C 0.67 25MG 0 2022-04-01 2024-03-31 0
40 7281K NEUROTOPREL 25MG TAB (ABB/PHA) TOPIRAMATE (C) 30'S C 0.6707 25MG 2022-04-01 2023-03-31 No No Delete from contract 0
41 7281L TOPIRAMATE 25MG TAB (CAM) (BP) 60'S BP 0.0829 25MG 60 2024-04-01 2026-03-31 6
40 72831 TOPAMAX 100MG TAB (JAC/STO) TOPIRAMATE 20'S C 2.93 100MG 0 2022-04-01 2024-03-31 0
41 72831 TOPAMAX 100MG TAB (JAC) TOPIRAMATE (C) 20'S C 2.9276 100MG 120 2024-04-01 2026-03-31 6
42 72831 TOPAMAX 100MG TAB (JAC) TOPIRAMATE 20'S C 2.93 100MG 120 2026-04-01 No No 6
40 72833 APO-TOPIRAMATE 100MG TAB (APO/COL) 100'S BP 0.17 100MG 0 2022-04-01 2024-03-31 0
42 72833 APO-TOPIRAMATE 100MG TAB (APO) 100'S BP 0.17 100MG 120 2026-04-01 No No 0
41 7283G TOPIRAMATE 100MG TAB (CIP) (BP) 60'S BP 0.1581 100MG 120 2024-04-01 2025-03-10 6
40 7283Q NEUROTOPREL 100MG TAB (ABB/PHA) TOPIRAMATE 30'S C 2.44 100MG 0 2022-04-01 2024-03-31 0