Displaying 5921 - 5940 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 B4513 NATRIXAM 5MG|1.5MG MR TAB (SER) AMLODIPINE|INDAPAMIDE 30'S A 0.25 5MG|1.5MG 30 2026-04-01 No No 6
40 B4514 NATRIXAM 10MG | 1.5MG TAB (SER/COL) AMLODIPINE | INDAPAMIDE 30'S A 0.24 10MG|1.5MG 30 2022-04-01 2024-03-31 6
41 B4514 NATRIXAM 10MG|1.5MG MR TAB (SER) AMLODIPINE|INDAPAMIDE 30'S A 0.2465 10MG|1.5MG 30 2024-04-01 2024-05-31 6
41 B4514 NATRIXAM 10MG|1.5MG MR TAB (SER) AMLODIPINE|INDAPAMIDE (C) 30'S C 0.2463 10MG|1.5MG 30 2024-06-01 2026-03-31 6
42 B4514 NATRIXAM 10MG|1.5MG MR TAB (SER) AMLODIPINE|INDAPAMIDE 30'S A 0.25 10MG|1.5MG 30 2026-04-01 No No 6
41 B451E AMLODIPINE/INDAPAMIDE 10MG|1.5MG MR TAB (HEA) AMLODIPINE|IND 3X10 A 0.124 10MG|1.5MG 30 2024-04-09 2026-03-31 6
41 B451F AMLODIPINE/INDAPAMIDE 5MG|1.5MG MR TAB (HEA) AMLODIPINE|INDA 3X10 A 0.1213 5MG|1.5MG 30 2024-04-09 2026-03-31 6
41 B4612 XIGDUO 5MG|1G TAB (AZN) DAPAGLIFLOZIN|METFORMIN 30'S A 1.312 5MG|1G 30 2024-04-01 2024-06-30 6
41 B4612 XIGDUO 5MG|1G TAB (AZN) DAPAGLIFLOZIN|METFORMIN 30'S B 1.312 5MG|1G 30 2024-08-16 2026-03-31 6
42 B4612 XIGDUO 5MG|1G XR TAB (AZN) DAPAGLIFLOZIN|METFORMIN 30'S C 1.36 5MG|1G 30 2026-04-01 No No 0
41 B4613 DAPAGLIFLOZIN|METFORMIN 5MG|1G TAB (KWA) 30'S A 0.2773 5MG|1G 30 2024-04-01 2026-03-31 6
42 B4616 DAPAGLIFLOZIN|METFORMIN 5MG|1G TAB (ZHL) 3X10 A 0.21 5MG|1G 30 2026-04-01 No No 6
41 B4622 XIGDUO 10MG|1G TAB (AZN) DAPAGLIFLOZIN|METFORMIN 30'S A 2.0532 10MG|1G 30 2024-04-01 2024-06-30 6
41 B4622 XIGDUO 10MG|1G TAB (AZN) DAPAGLIFLOZIN|METFORMIN 30'S B 2.0533 10MG|1G 30 2024-08-16 2026-03-31 6
42 B4622 XIGDUO 10MG|1G XR TAB (AZN) DAPAGLIFLOZIN|METFORMIN 30'S C 2.05 10MG|1G 30 2026-04-01 No No 0
40 B4623 SYNJARDY 12.5/850MG 60'S A $1.120 12.5MG /850MG 60 2022-10-31 2024-03-31 6
41 B4623 SYNJARDY 12.5MG|850MG (BOE) EMPAGLIFLOZIN|METFORMIN 60'S A 1.1209 12.5MG|850MG 60 2024-04-01 2026-03-31 6
42 B4623 SYNJARDY 12.5MG|850MG (BOE) EMPAGLIFLOZIN|METFORMIN 60'S A 1.12 12.5MG|850MG 60 2026-04-01 No No 6
40 B4624 SYNJARDY 12.5/1 G TAB (STO/BOE) 60'S A $1.120 12.5/1GRAM 60 2022-10-31 2024-03-31 6
41 B4624 SYNJARDY 12.5MG|1G (BOE) EMPAGLIFLOZIN|METFORMIN 60'S A 1.1209 12.5MG|1G 60 2024-04-01 2026-03-31 6