Displaying 5401 - 5420 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 A692E APO-OXCARBAZEPINE 600MG TAB (APO) O 100'S A 0.80 600MG 120 2026-04-01 No No 6
41 A692F OXCARBAZEPINE 600MG TAB (CAM) 50'S A 0.7535 600MG 120 2024-04-01 2026-03-31 6
41 A692H APO-OXCARBAZEPINE 600MG TAB (APO) O 100'S A 0.8041 600MG 120 2024-04-01 2026-03-31 6
40 A6931 TRILEPTAL 60MG/ML SUSP (NVS/COL) OXCARBAZEPIN 100ML A 0.27 60MG/ML 600 2022-04-01 2024-03-31 6
41 A6931 TRILEPTAL 60MG/ML SUSP (NVS) OXCARBAZEPI 100ML A 0.2735 60MG/ML 600 2024-04-01 2026-03-31 6
42 A6931 TRILEPTAL 60MG/ML SUSP (NVS) OXCARBAZEPI 100ML A 0.27 60MG/ML 600 2026-04-01 No No 6
40 A7017 PILOCARPINE | TIMOLOL 2% | 0.5% EYE DR (FSB/ATB) 5ML A 5.76 2%|0.5% 1 2022-04-01 2024-03-31 Price Change 6
42 A7019 PILOCARPINE|TIMOLOL 2%|0.5% EYE DR (CHC) 5ML A 19.52 2%|0.5% 1 2026-04-01 No No Add to Contract as Cat A 6
40 A7026 PILOCARPINE | TIMOLOL 4% | 0.5% EYE DR (FSB/ATB) 5ML A 7.04 4%|0.5% 1 2022-04-01 2024-03-31 Price Change 6
40 A7111 RISPERDAL 2MG TAB (JAC/STO) RISPERIDONE 20'S BP 0.97 2MG 60 2022-04-01 2024-03-31 6
41 A7111 RISPERDAL 2MG TAB (JAC) RISPERIDONE (C) 20'S C 0.9704 2MG 60 2024-04-01 2026-03-31 6
42 A7111 RISPERDAL 2MG TAB (JAC) RISPERIDONE 20'S C 0.97 2MG 60 2026-04-01 No No 6
40 A7117 APO-RISPERIDONE 2MG TAB (APO/COL) 100'S A 0.11 2MG 60 2022-04-01 2024-03-31 6
42 A7117 APO-RISPERIDONE 2MG TAB (APO) 100'S A 0.11 2MG 60 2026-04-01 No No 6
40 A711AB RISPERIDONE 2MG TAB (INP/AHI) 50'S A 0.02 2MG 60 2022-04-01 2022-09-30 6
41 A711AB RISDONE 2MG TAB (INP) RISPERIDONE 50'S A 0.0897 2MG 60 2024-04-01 2026-03-31 6
42 A711AB RISDONE 2MG TAB (INP) RISPERIDONE 50'S A 0.09 2MG 60 2026-04-01 No No 6
40 A711AK RISDONE 2MG TAB (INP/AHI) RISPERIDONE 60'S A 0.13 2MG 60 2022-04-01 2024-03-31 6
41 A711AL APO-RISPERIDONE 2MG TAB (APO) 100'S A 0.1109 2MG 60 2024-04-01 2026-03-31 6
40 A7121 RISPERDAL 1MG TAB (JAC/STO) RISPERIDONE 20'S BP 0.97 1MG 60 2022-04-01 2024-03-31 6