Displaying 4581 - 4600 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
40 7283Q NEUROTOPREL 100MG TAB (ABB/PHA) TOPIRAMATE (C) 30'S C 2.4373 100MG 2022-04-01 2023-03-31 No No Delete from contract 0
41 7283S APO-TOPIRAMATE 100MG TAB (APO) (BP) 100'S BP 0.1699 100MG 120 2024-04-01 2026-03-31 6
41 7283T TOPIRAMATE 100MG TAB (ZYD) 60'S BP 0.1582 100MG 120 2025-01-27 2026-03-31 6
40 72841 TOPAMAX 50MG TAB (JAC/STO) TOPIRAMATE 20'S C 1.97 50MG 0 2022-04-01 2024-03-31 0
41 72841 TOPAMAX 50MG TAB (JAC) TOPIRAMATE (C) 20'S C 1.9721 50MG 90 2024-04-01 2026-03-31 6
42 72841 TOPAMAX 50MG TAB (JAC) TOPIRAMATE 20'S C 1.97 50MG 90 2026-04-01 No No 6
40 72849 TOPIRAMATE 50MG TAB (CIP/AHI) 60'S BP 0.12 50MG 0 2022-04-01 2022-09-30 0
40 7284D TOPAZ 50MG TAB (INP/AAL) TOPIRAMATE 60'S BP 0.16 50MG 0 2022-04-01 2024-03-31 6
40 7284E NEUROTOPREL 50MG TAB (ABB/PHA) TOPIRAMATE 30'S C 1.68 50MG 0 2022-04-01 2024-03-31 0
40 7284E NEUROTOPREL 50MG TAB (ABB/PHA) TOPIRAMATE (C) 30'S C 1.6753 50MG 2022-04-01 2023-03-31 No No Delete from contract 0
40 73512 VASTAREL MR 35MG TAB (SER/STO) TRIMETAZIDINE 30'S C 0.55 35MG 0 2022-04-06 2024-03-31 Package Size Change 0
40 73516 TRIMETAZIDINE 20MG TAB (HEA/RXP) 10X10 A 0.10 20MG 90 2022-04-01 2024-03-31 6
40 7351F VASTAREL MR 35MG TAB (SER/COL) TRIMETAZIDINE 30'S C 0.55 35MG 0 2022-04-13 2024-03-31 Add to Contract as Cat C 0
40 7351K VASTAREL MR 35MG TAB (SER/COL) TRIMETAZIDINE 60'S C 0.55 35MG 0 2022-04-01 2024-03-31 0
41 7351K VASTAREL 35MG MR TAB (SER) TRIMETAZIDINE (C) 60'S C 1.1417 35MG 0 2024-04-01 2026-03-31 0
42 7351K VASTAREL 35MG MR TAB (SER) TRIMETAZIDINE 60'S C 1.14 35MG 0 2026-04-01 No No 0
40 7351L VASTAREL MR 35MG TAB (SER/STO) TRIMETAZIDINE 60'S C 0.55 35MG 0 2022-04-01 2024-03-31 0
41 7351L VASTAREL 35MG MR TAB (SER) TRIMETAZIDINE (C) 60'S C 1.1417 35MG 0 2024-04-01 2026-03-31 0
42 7351L VASTAREL 35MG MR TAB (SER) TRIMETAZIDINE 60'S C 1.14 35MG 0 2026-04-01 No No 0
40 7351M CARDIZINE 20MG TAB (AUR/AHI) TRIMETAZIDINE 60'S A 0.09 20MG 90 2022-04-01 2024-03-31 6