Displaying 521 - 540 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 07221 CALCORT 30MG TAB (SFA/COL) DEFLAZACORT 10'S C 3.81 30MG 0 2022-04-01 2024-03-31 0
40 07229 AVEXA 30MG TAB (MBL/AHI) DEFLAZACORT 1X10 C 2.90 30MG 0 2022-04-01 2024-03-31 Add to Contract as Cat C 0
41 0722B DEFLAZACORT 30MG TAB (KWA) (C) 10'S C 1.3864 30MG 0 2024-04-01 2026-03-31 0
42 0722C DEFJOHN 30MG TAB (JLP) DEFLAZACORT 10X10 C 0.11 30MG 0 2026-04-01 No No 0
41 07311 APO-TRIHEX 2MG TAB (APO) 100'S A 0.1327 2MG 180 2024-04-01 2026-03-31 6
40 07315 BENZHEXOL 2MG TAB (KWA/ATB) 10X10 A 0.49 2MG 180 2022-04-01 2024-03-31 6
41 07321 APO-TRIHEX 5MG TAB (APO) 100'S A 0.1541 5MG 90 2024-04-01 2026-03-31 6
40 0732A BENZHEXOL 5MG TAB (KWA/ATB) 10X10 A 1.14 5MG 90 2022-04-01 2024-03-31 6
40 07411 PMS-BENZTROPINE 2MG TAB (PMS/COL) 100'S A 0.10 2MG 90 2022-04-01 2024-03-31 6
41 0741E BENZTROPINE 2MG TAB (FSB) 10X10 A 0.0685 2MG 90 2024-04-01 2026-03-31 6
40 0741G BENZTROPINE 2MG TAB (KWA/ATB) 10X10 A 0.10 2MG 90 2022-04-01 2024-03-31 6
40 0741K BENCOGEN 2MG TAB (LDP/AHI) BENZTROPINE 1000'S A 0.08 2MG 90 2022-04-01 2024-03-31 6
41 0741L BENZTROPINE 2MG TAB (HEA) 10X10 A 0.0767 2MG 90 2024-04-01 2026-03-31 6
42 0741M BENZTROPINE 2MG TAB (LAB) 1000'S A 0.07 2MG 90 2026-04-01 No No 6
42 0741N BENZTROPINE 2MG TAB (HEA) 10X10 A 0.08 2MG 90 2026-04-01 No No Price Change 6
42 0741P BENZTROPINE 2MG TAB (HEA) 10X10 A 0.08 2MG 90 2026-04-01 No No Add to Contract as Cat A 6
42 0741Q BENZTROPINE 2MG TAB (HEA) 10X10 A 0.08 2MG 90 2026-04-01 No No Add to Contract as Cat A 6
42 0742L BENZTROPINE 1MG/ML INJ (MON) 5X2ML B 2.69 1MG/ML 6 2026-04-01 No No 6
40 0742W BENZTROPINE 1MG/ML INJ (FSB/ATB) 10X2ML B 2.59 1MG/ML 0 2022-04-01 2024-03-31 0
41 0742W BENZTROPINE 1MG/ML INJ (FSB) (B) 10X2ML B 2.316 1MG/ML 6 2024-04-01 2026-03-31 6