Displaying 5981 - 5993 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 B5931 AMLOTENSIVE CT 10MG | 25MG TAB (CAR/COL) AMLODIPINE | CHLORTHALIDONE 210'S A 0.13 10MG|25MG 30 2022-07-11 2024-03-31 Add to Contract as Cat A 6
41 B5931 AMLOTENSIVE CT 10MG|25MG TAB (CAR) AMLODIPINE|CHLORTHALIDONE 210'S A 0.125 10MG|25MG 30 2024-04-01 2026-03-31 6
42 B5931 AMLOTENSIVE CT 10MG|25MG TAB (CAR) AMLODIPINE|CHLORTHALIDONE 210'S A 0.13 10MG|25MG 30 2026-04-01 No No 6
40 B5941 AMLOTENSIVE CT 10MG | 50MG TAB (CAR/COL) AMLODIPINE | CHLORTHALIDONE 210'S A 0.17 10MG|50MG 30 2022-07-11 2022-03-31 Add to Contract as Cat A 6
41 B5941 AMLOTENSIVE CT 10MG|50MG TAB (CAR) AMLODIPINE|CHLORTHALIDONE 210'S A 0.171 10MG|50MG 30 2024-04-01 2026-03-31 6
42 B5941 AMLOTENSIVE CT 10MG|50MG TAB (CAR) AMLODIPINE|CHLORTHALIDONE 210'S A 0.17 10MG|50MG 30 2026-04-01 No No 6
41 B6211 GLYXAMBI 25MG|5MG TAB (BOE) EMPAGL (C) 30'S C 3.9597 25MG|5MG 0 2024-04-01 2026-03-31 0
41 B7111 NURTEC 75 MG TABS(PFI) RIMEGEPANT 2'S C 43.58 75
42 B7111 NURTEC 75MG TAB (PFI) RIMEGEPANT 2'S C 43.51 75MG 2 2026-04-01 No No 6
42 B7112 NURTEC 75MG TAB (PFI) RIMEGEPANT 8'S C 43.51 75MG 2 2026-04-01 No No 6
42 B8012 FIRIALTA 10MG TAB (BSP) FINERENONE (C) 28'S C 4.73 10MG 2026-04-01 No No Add to Contract as Cat C
42 B8021 FIRIALTA 20MG TAB (BSP) FINERENONE (C) 28'S C 4.73 20MG 2026-04-01 No No Add to Contract as Cat C
0 Brand C Brand Name Package Si Fo Unit Pric Strength 0