Displaying 5681 - 5700 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 B041LE NEXIUM 10MG GRAN (AZN) ESOMEPRAZOLE 28'S C 1.71 10MG 0 2026-04-01 No No 0
40 B041LG ESOMEPRAZOLE 20MG TAB (KWA/ATB) 10X10 C 0.19 20MG 0 2022-04-01 2024-03-31 0
40 B041LH PANTOPRAZOLE 40MG TAB (KWA/ATB) 100'S C 0.09 40MG 0 2022-04-01 2024-03-31 0
40 B041LQ EMEP 40MG CAP (ARP/AHI) ESOMEPRAZOLE 40'S C 0.41 40MG 0 2022-04-01 2024-03-31 Add to Contract as Cat C 0
41 B041LS PROTON-P 20MG TAB (ARP) PANTOPRAZOL (C) 60'S C 0.159 20MG 0 2024-04-01 2026-03-31 0
40 B041MH OMEPRAZOLE 20MG TAB (MCP/AHI) 2X10 A 0.04 20MG 30 2022-04-01 2024-03-31 6
41 B041MH OMEPRAZOLE 20MG TAB (MCP) 2X10 A 0.0448 20MG 30 2024-04-01 2026-03-31 6
40 B041NJ OMEPRAZOLE 20MG CAP (FSB/ATB) 100'S A 0.07 20MG 30 2022-04-01 2024-03-31 Add to Contract as Cat A 6
41 B041NP APO-LANSOPRAZOLE 15MG CAP (APO) (C) 100'S C 0.1068 15MG 0 2024-04-01 2026-03-31 0
41 B041NR APO-PANTOPRAZOLE 40MG TAB (APO) (C) 100'S C 0.1411 40MG 7 2024-04-01 2026-03-31 0
41 B041NT APO-LANSOPRAZOLE 30MG CAP (APO) (C) 100'S C 0.2031 30MG 0 2024-04-01 2026-03-31 0
41 B041PD ESOMAC 20MG TAB (MPI) ESOMEPRAZOLE (C) 3X10 C 0.1205 20MG 0 2024-04-01 2026-03-31 0
41 B041PE ESOMAC 40MG TAB (MPI) ESOMEPRAZOLE (C) 3X10 C 0.1395 40MG 0 2024-04-01 2026-03-31 0
41 B041PK OMEVAN 20MG CAP (TPP) OMEPRAZOLE 10X10 A 0.0201 20MG 30 2024-04-01 2026-03-31 6
41 B041PL OMETAB 20MG TAB (INP) OMEPRAZOLE 3X10 A 0.0498 20MG 30 2024-04-01 2026-03-31 6
42 B041PT OMELONIM 20MG CAP (ANC) OMEPRAZOLE 30'S A 0.04 20MG 60 2026-04-01 No No 6
42 B041QD JUNIOR LANZOL 15MG CHEW TAB (CIP) LANSOPRAZOLE 120'S C 0.67 15MG 0 2026-04-01 No No 0
42 B041QJ OMEPRAZOLE 20MG CAP (HEA) 3X10 A 0.07 20MG 60 2026-04-01 No No Price Change 6
42 B041QT OMEPRAZOLE 20MG CAP (HEA) 3X10 A 0.07 20MG 60 2026-04-01 No No Add to Contract as Cat A 6
42 B041QU OMEPRAZOLE 20MG CAP (HEA) 30'S A 0.07 20MG 60 2026-04-01 No No Add to Contract as Cat A 6