Displaying 5801 - 5820 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 B1533 XARELTO 20MG TAB (BSP/AHI) RIVAROXABAN 28'S C 6.07 20MG 0 2022-04-01 2024-03-31 0
41 B1533 XARELTO 20MG TAB (BSP) RIVAROXABAN (C) 28'S C 6.0687 20MG 30 2024-04-01 2026-03-31 0
42 B1533 XARELTO 20MG TAB (BSP) RIVAROXABAN 28'S C 3.04 20MG 30 2026-04-01 No No 0
40 B1534 XARELTO 20MG TAB (BSP/COL) RIVAROXABAN 28'S C 6.07 20MG 0 2022-04-01 2024-03-31 0
41 B1534 XARELTO 20MG TAB (BSP) RIVAROXABAN (C) 28'S C 6.0687 20MG 30 2024-04-01 2026-03-31 0
42 B1534 XARELTO 20MG TAB (BSP) RIVAROXABAN 28'S C 2.76 20MG 30 2026-04-01 No No 0
40 B1535 XARELTO 20MG TAB (BSP/AHI) RIVAROXABAN 14'S C 6.07 20MG 0 2022-04-01 2024-03-31 0
41 B1535 XARELTO 20MG TAB (BSP) RIVAROXABAN (C) 14'S C 6.0696 20MG 30 2024-04-01 2026-03-31 0
40 B1536 XARELTO 20MG TAB (BSP/COL) RIVAROXABAN 14'S C 6.07 20MG 0 2022-04-01 2024-03-31 0
41 B1536 XARELTO 20MG TAB (BSP) RIVAROXABAN (C) 14'S C 6.0696 20MG 30 2024-04-01 2026-03-31 0
42 B153L PMS-RIVAROXABAN 20MG TAB (PMS) 100'S B 1.06 20MG 30 2026-04-01 No No 0
42 B153R DEBIJOHN 150MG CAP (JLP) DABIGATRAN 10X10 B 0.65 150MG 60 2026-04-01 No No 6
40 B2212 APIDRA SOLOSTAR 100IU/ML INJ (SFA/COL) GLULIS 3ML VIAL A 19.71 100IU/ML 4 2022-04-01 2024-03-31 6
41 B2212 APIDRA SOLOSTAR 100U/ML INJ (SFA) INSULIN GLULISINE 3ML VIAL A 19.7078 100U/ML 2 2024-04-01 2026-03-31 6
42 B2212 APIDRA SOLOSTAR 100U/ML INJ (SFA) INSULIN GLULISINE 3ML VIAL A 19.71 100U/ML 2 2026-04-01 No No 6
40 B2213 APIDRA 100U/ML INJ (SFA/COL) GLULISINE 10ML VIAL A 54.37 100U/ML 5 2022-04-01 2024-03-31 6
41 B2213 APIDRA 100U/ML INJ (SFA) INSULIN GLULISINE 10ML VIAL A 54.3665 100U/ML 5 2024-04-01 2026-03-31 6
42 B2213 APIDRA 100U/ML INJ (SFA) INSULIN GLULISINE 10ML VIAL A 54.37 100U/ML 5 2026-04-01 No No 6
40 B2214 NOVORAPID FLEXPENS 100U/ML (NOV/COL) ASPART 5X3ML A 17.67 100U/ML 1 2022-04-01 2024-03-31 6
41 B2214 NOVORAPID FLEXPENS 100U/ML INJ (NOV) INSULIN ASPART 5X3ML A 17.67 100U/ML 2 2024-04-01 2026-03-31 6