Displaying 5241 - 5260 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 A5028 DIOVAN 160MG TAB (NVS/COL) VALSARTAN 28'S A 0.65 160MG 30 2022-04-01 2024-03-31 6
41 A5028 DIOVAN 160MG TAB (NVS) VALSARTAN 28'S A 0.6485 160MG 30 2024-04-01 2026-03-31 6
42 A5028 DIOVAN 160MG TAB (NVS) VALSARTAN 28'S A 0.56 160MG 30 2026-04-01 No No 6
40 A5029 DIOVAN 320MG TAB (NVS/COL) VALSARTAN 28'S A 0.70 320MG 30 2022-04-01 2024-03-31 6
41 A5029 DIOVAN 320MG TAB (NVS) VALSARTAN 28'S A 0.6961 320MG 30 2024-04-01 2026-03-31 6
42 A5029 DIOVAN 320MG TAB (NVS) VALSARTAN 28'S A 0.70 320MG 30 2026-04-01 No No 6
42 A502AC LOSARTAN 100MG TAB (FSB) 30'S A 0.07 100MG 30 2026-04-01 No No Add to Contract as Cat A 6
40 A502B PMS-LOSARTAN 100MG TAB (PMS/COL) 100'S A 0.24 100MG 30 2022-04-01 2024-03-31 6
41 A502BL LOSARTAN 100MG TAB (KWA) 28'S A 0.0893 100MG 30 2024-04-01 2026-03-31 6
40 A502CY LOSARTAN 100MG TAB (MCP/AHI) 3X10 A 0.19 100MG 30 2022-04-01 2024-03-31 6
41 A502DM PRESARTAN 100MG TAB (IPC) LOSARTAN 100'S A 0.0614 100MG 30 2024-04-01 2026-03-31 6
40 A5213 SURVANTA 25MG/ML INJ (ABB/PHA) BERACTANT 8ML VIAL BQ 1,043.59 25MG/ML 0 2022-04-01 2024-03-31 0
41 A5213 SURVANTA 25MG/ML INJ (ABB) BERACTANT (BQ) 8ML VIAL BQ 1042.3957 25MG/ML 50 2024-04-01 2026-03-31 0
42 A5213 SURVANTA 25MG/ML INJ (ABB) BERACTANT 8ML VIAL BQ 992.19 25MG/ML 50 2026-04-01 No No 0
40 A5311 XALATAN 0.005% EYE DR (PFI/STO) LATANOPROST 2.5ML A 11.66 0.005% 1 2022-04-01 2024-03-31 Price Change 6
40 A5319 GLAUCOPROST 0.004% EYE DR (LPO/COL) TRAVOPROS 3ML A 10.60 0.004% 1 2022-04-01 2024-03-31 6
41 A5319 GLAUCOPROST 0.004% EYE DR (LPO) TRAVOPRO (C) 3ML C 11.6616 0.004% 1 2024-04-01 2026-03-31 Yes 6
42 A5319 GLAUCOPROST 0.004% EYE DR (LPO) TRAVOPRO 3ML C 17.67 0.004% 1 2026-04-01 No No 6
40 A531AH LOUTEN EMULSION 0.005% EYE DR (LPO/COL) LATAN 2.5ML A 9.08 0.005% 1 2022-04-01 2024-03-31 6
41 A531AH LOUTEN EMULSION 0.005% EYE DR (LPO) LATA 2.5ML A 9.0792 0.005% 1 2024-04-01 2026-03-31 Yes 6