Displaying 4821 - 4840 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 7811AC PROTRIDE 5MG TAB (HEA) FINASTERIDE 3X10 A 0.2274 5MG 30 2024-04-01 2026-03-31 6
41 7811AE FINASTERIDE 5MG TAB (FSB) 30'S A 0.2012 5MG 30 2024-04-01 2026-03-31 6
42 7811AJ PROTRIDE 5MG TAB (HEA) FINASTERIDE 3X10 A 0.22 5MG 30 2026-04-01 No No Price Change 6
42 7811AL PROTRIDE 5MG TAB (HEA) FINASTERIDE 3X10 A 0.22 5MG 30 2026-04-01 No No Add to Contract as Cat A 6
42 7811AM PROTRIDE 5MG TAB (HEA) FINASTERIDE 3X10 A 0.22 5MG 30 2026-04-01 No No Add to Contract as Cat A 6
40 7811M PMS-FINASTERIDE 5MG TAB (PMS/COL) 30'S A 0.18 5MG 30 2022-04-01 2024-03-31 6
40 7811P PROTRIDE 5MG TAB (HEA/RXP) FINASTERIDE 3X10 A 0.23 5MG 30 2022-04-01 2024-03-31 6
40 7911AA APO-CYCLOBENZAPRINE 10MG TAB (APO/COL) 500'S A 0.54 10MG 42 2022-04-01 2024-03-31 Package Size Change 6
41 7911AB APO-CYCLOBENZAPRINE 10MG TAB (APO) 500'S A 0.5438 10MG 42 2024-04-01 2026-03-31 6
42 7911AC APO-TIZANIDINE 4MG TAB (APO) 100'S A 0.10 4MG 21 2026-04-01 No No 0
42 7911AF NORGESIC 35MG|500MG TAB (GRM) ORPHENADRINE|PARACETAMOL 5X10 C 0.68 35MG|500MG 0 2026-04-01 No No 0
41 7911Q TIZANIDINE 4MG TAB (DRL) 150'S A 0.1167 4MG 21 2024-04-01 2026-03-31 0
40 7911R NORGESIC 35MG | 500MG TAB (PMA/AHI) ORPHENADRINE | PARACETAMOL 10'S C 0.71 35MG|500MG 0 2022-04-01 2024-03-31 0
41 7911R NORGESIC 35MG|500MG TAB (PMA) ORPHENADRINE|PARACETAMOL (C) 10'S C 0.8155 35MG|500MG 0 2024-04-01 2026-03-31 0
40 7911T TIZANIDINE 4MG TAB (KWA/ATB) 10X10 A 0.30 4MG 21 2022-04-01 2024-03-31 0
42 7911W CYCLOBENZAPRINE 10MG TAB (CIP) 100'S A 0.10 10MG 42 2026-04-01 No No 6
40 7911Y SIRDALUD 4MG TAB (BCH/COL) TIZANIDINE 30'S C 0.68 4MG 0 2022-04-01 2024-03-31 0
41 7911Y SIRDALUD 4MG TAB (BCH) TIZANIDINE (C) 30'S C 0.6814 4MG 21 2024-04-01 2026-03-31 0
42 7911Y SIRDALUD 4MG TAB (BCH) TIZANIDINE 30'S C 0.77 4MG 21 2026-04-01 No No 0
40 7912E ORPHENADRINE 30MG/ML INJ (AKI/AHI) 10X2ML C 69.01 30MG/ML 0 2022-04-01 2022-09-30 0