Displaying 4981 - 5000 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 A2712 FML LIQUIFILM 0.1% EYE DR (ALL) FLUOROME 5ML C 17.67 0.1% 0 2026-04-01 No No 0
40 A271A AFM 0.1% EYE DR (ARP/AHI) FLUOROMETHOLONE 5ML BQ 6.58 0.1% 0 2022-04-01 2024-03-31 6
41 A271A AFM 0.1% EYE DR (ARP) FLUOROMETHOLONE (BQ) 5ML BQ 7.421 0.1% 0 2024-04-01 2026-03-31 0
41 A271C E-FLOW 0.1% EYE DR (SHC) FLUOROMETHOLONE (BQ) 5ML BQ 4.0775 0.1% 0 2024-04-01 2026-03-31 0
42 A271C E-FLOW 0.1% EYE DR (SHC) FLUOROMETHOLONE 5ML BQ 4.29 0.1% 0 2026-04-01 No No 0
40 A2921 ARAVA 20MG TAB (SFA/COL) LEFLUNOMIDE 30'S C 3.17 20MG 0 2022-04-01 2024-03-31 0
41 A2921 ARAVA 20MG TAB (SFA) LEFLUNOMIDE (C) 30'S C 3.1714 20MG 0 2024-04-01 2026-03-31 0
42 A2921 ARAVA 20MG TAB (SFA) LEFLUNOMIDE 30'S C 3.17 20MG 0 2026-04-01 No No 0
40 A3131 SAIZEN 6MG INJ (MEK/COL) SOMATROPIN VIAL C 247.10 6MG 0 2022-04-01 2024-03-31 0
40 A321AH VENLAFAXINE ER 37.5MG TAB (APL/AHI) VENLAFAXI 30'S BP 0.36 37.5MG 0 2022-04-01 2024-03-31 6
41 A321AJ VENLAFAXINE 37.5MG TAB (ZYD) 100'S BP 0.1115 37.5MG 42 2024-04-01 2026-03-31 6
42 A321AJ VENLAFAXINE 37.5MG TAB (ZYD) 100'S BP 0.12 37.5MG 42 2026-04-01 No No 0
42 A321AK APO-SERTRALINE 50MG CAP (APO) 100'S A 0.12 50MG 42 2026-04-01 No No 6
42 A321AL ZOLOFT 50MG TAB (PFI) SERTRALINE 14'S C 1.41 50MG 42 2026-04-01 No No 0
42 A321AR PAXIL 12.5MG CR CAP (GSK) PAROXETINE 30'S C 1.80 12.5MG 0 2026-04-01 No No 0
42 A321AS LEEPAROX 12.5MG CR TAB (JLP) PAROXETINE 100'S BP 0.13 12.5MG 0 2026-04-01 No No 0
42 A321AT SETMAX 50MG TAB (JLP) SERTRALINE 10X10 A 0.12 50MG 42 2026-04-01 No No 6
40 A321S VENLAFAXINE SR 37.5MG CAP (CIP/AHI) 100'S BP 0.35 37.5MG 0 2022-04-01 2024-03-31 6
40 A3221 APO-FLUOXETINE 20MG CAP (APO/COL) 100'S A 0.08 20MG 120 2022-04-01 2024-03-31 6
42 A3221 APO-FLUOXETINE 20MG CAP (APO) 100'S A 0.08 20MG 120 2026-04-01 No No 6