Displaying 5861 - 5880 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
41 B2256 NOVOMIX 70|30 FLEXPENS 100U/ML INJ (NOV) ASPART 5X3ML A 24.464 100U/ML 2 2024-04-01 2026-03-31 6
42 B2256 NOVOMIX 70|30 FLEXPENS 100U/ML INJ (NOV) INSULIN ASPART 5X3ML A 24.46 100U/ML 2 2026-04-01 No No 6
41 B2258 HUMALOG 75%|25% INJ (LIL) INSULIN ISOPHANE|INSULIN REGULAR (C) 5X3ML C 26.9386 75%|25% 0 2024-04-01 2026-03-31 0
40 B225A HUMULIN CARTRIDGE 70% | 30% INJ (LIL/STO) INSULIN ISOPHANE | INSULIN REGULAR 5X3ML A 9.41 70%|30% 5 2022-04-01 2024-03-31 6
41 B225A HUMULIN CARTRIDGE 70%|30% INJ (LIL) INSULIN ISOPHANE|INSULIN (C) 5X3ML C 52.41 70%|30% 5 2024-04-01 2026-03-31 6
40 B225B NOVOLIN PENFIL 70% | 30% INJ (NOV/COL) INSULIN ISOPHANE | INSULIN REGULAR 5X3ML C 12.24 70%|30% 0 2022-04-01 2024-03-31 0
41 B225B NOVOLIN PENFIL 70%|30% INJ (NOV) INSULIN ISOPHANE|INSULIN RE (C) 5X3ML C 12.2325 70%|30% 5 2024-04-01 2026-03-31 6
42 B225B NOVOLIN PENFIL 70%|30% INJ (NOV) INSULIN ISOPHANE|INSULIN RE 5X3ML A 12.23 70%|30% 5 2026-04-01 No No 6
41 B225D HUMALOG KWIKPEN 75%|25% INJ (LIL) INSULIN ISOPHANE|INSULIN R (C) 5X3ML C 27.8574 75%|25% 0 2024-04-01 2026-03-31 6
42 B2711 TRAJENTA 5MG TAB (BOE) LINAGLIPTIN 30'S C 3.82 5MG 0 2026-04-01 No No 0
40 B2712 GALVUS 50MG TAB (NVS/COL) VIDAGLIPTIN 56'S B 0.58 50MG 60 2022-04-01 2024-03-31 6
41 B2712 GALVUS 50MG TAB (NVS) VILDAGLIPTIN (C) 56'S C 0.5825 50MG 60 2024-04-01 2026-03-31 6
42 B2712 GALVUS 50MG TAB (NVS) VILDAGLIPTIN 56'S C 0.49 50MG 60 2026-04-01 No No 6
40 B2713 JANUVIA 50MG TAB (MSD/STO) SITAGLIPTIN 28'S C 2.52 50MG 0 2022-04-01 2024-03-31 0
41 B2713 JANUVIA 50MG TAB (MSD) SITAGLIPTIN (C) 28'S C 2.397 50MG 0 2024-04-01 2026-03-31 0
40 B2714 JANUVIA 100MG TAB (MSD/STO) SITAGLIPTIN 28'S C 2.52 100MG 0 2022-04-01 2024-03-31 0
41 B2714 JANUVIA 100MG TAB (MSD) SITAGLIPTIN (C) 28'S C 2.397 100MG 0 2024-04-01 2026-03-31 0
42 B271A VILDALION 50MG TAB (STL) VIDAGLIPTIN 30'S B 0.06 50MG 60 2026-04-01 No No 6
42 B271AQ SITADIET 50MG TAB (JLP) SITAGLIPTIN 10X10 C 0.15 50MG 0 2026-04-01 No No 0
41 B271E REMEVIA 100MG TAB (REM) SITAGLIPTIN (C) 28'S C 0.4262 100MG 0 2024-04-01 2026-03-31 0