Displaying 5601 - 5620 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 A9624 DIFFERIN PUMP 0.3% GEL (DPT/STO) ADAPALENE 45G C 204.74 0.3% 0 2022-04-01 2024-03-31 0
41 A9626 ADAPALENE 0.6% GEL (WAT) (C) 45G C 169.2157 0.6% 0 2024-04-01 2026-03-31 0
42 A9628 DERIVA 0.1% GEL (GLP) ADAPALENE (C) 45G C 14.95 0.1% 0 2026-04-01 No No 0
40 A9631 DIFFERIN 0.1% CR (DPT/STO) ADAPALENE 45G C 65.86 0.1% 0 2022-04-01 2024-03-31 0
40 A9632 DERIVA 0.1% CR (GLP/ALI) ADAPALENE 15G C 16.31 0.1% 0 2022-04-01 2022-03-22 Delete from contract 0
40 A9634 DERIVA 0.1% GEL (GLN/ALI) ADAPALENE 45G C 29.90 0.1% 0 2022-04-01 2024-03-31 0
40 A9635 DERIVA 0.1% CR (GLP/ATB) ADAPALENE 15G C 16.31 0.1% 0 2022-04-01 2024-03-31 Change Local Agent 0
41 A9811 HYPERIUM 1MG TAB (SER) RILMENIDINE (C) 30'S C 0.7385 1MG 60 2024-04-01 2026-03-31 6
41 A9812 HYPERIUM 1MG TAB (SER) RILMENIDINE (C) 30'S C 0.7385 1MG 60 2024-04-01 2026-03-31 6
40 A9813 RILMENIDINE 1MG TAB (KWA/ATB) 3X10 C 3.26 1MG 0 2022-04-01 2024-03-31 0
41 A992P TOLTERODINE XL 2MG SR TAB (TEV) (C) 28'S C 0.4485 2MG 0 2024-04-01 2026-03-31 0
40 A992Q DETRUSITOL SR 2MG TAB (PFI/STO) TOLTERODINE 30'S C 2.22 2MG 0 2022-04-01 2024-03-31 0
41 A992Q DETRUSITOL 2MG SR TAB (PFI) TOLTERODINE (C) 30'S C 2.2381 2MG 0 2024-04-01 2026-03-31 0
40 A992R DETRUSITOL SR 2MG TAB (PFI/SBI) TOLTERODINE 30'S C 2.22 2MG 0 2022-04-01 2024-03-31 0
41 A992R DETRUSITOL 2MG SR TAB (PFI) TOLTERODINE (C) 30'S C 2.2381 2MG 0 2024-04-01 2026-03-31 0
42 A992S DETRUSITOL 2MG SR CAP (PFI) TOLTERODINE 30'S C 2.24 2MG 0 2026-04-01 No No 0
40 A9933 DETRUSITOL SR 4MG TAB (PFI/SBI) TOLTERODINE 30'S C 4.44 4MG 0 2022-04-01 2024-03-31 0
40 A993G DETRUSITOL 4MG TAB (PFI/STO) TOLTERODINE 30'S C 4.44 4MG 0 2022-04-01 2024-03-31 0
41 A993G DETRUSITOL 4MG TAB (PFI) TOLTERODINE (C) 30'S C 4.4753 4MG 0 2024-04-01 2026-03-31 0
41 A993H DETRUSITOL LA 4MG CAP (PFI) TOLTERODINE (C) 30'S C 4.4753 4MG 0 2024-04-01 2026-03-31 0