Displaying 741 - 760 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 1132FW ROSUVASTATIN 10MG TAB (MSN/AHI) 30'S A 0.14 10MG 30 2022-04-01 2022-09-30 6
41 1132GL ROSUVASTATIN 10MG TAB (MSN) 30'S A 0.0861 10MG 30 2024-04-01 2026-03-31 6
40 1132GM ROSUVASTATIN 10MG TAB (RYV/ATB) 30'S A 0.13 10MG 30 2022-04-01 2024-03-31 6
40 1132GQ ROSUMAC 10MG TAB (MCP/AHI) ROSUVASTATIN 3X10 A 0.09 10MG 30 2022-04-01 2024-03-31 6
41 1132GS ATORVASTATIN 20MG TAB (TPP) 10X10 A 0.0503 20MG 30 2024-04-01 2026-03-31 6
40 1132GU ATORVASTATIN 20MG TAB (UME/AHI) 3X10 A 0.16 20MG 30 2022-04-01 2022-10-19 Delete from contract 6
40 1132GU ATORVASTATIN 20MG TAB (UME/AHI) 3X10 A 0.058 20MG 30 2023-03-20 2024-03-31 No No Add to Contract as Cat A 6
40 1132HE LIPITAS 20MG TAB (INP/AHI) ATORVASTATIN 30'S A 0.144 20MG 30 2023-03-20 2024-03-31 No No Add to Contract as Cat A 6
41 1132HF ROSUVASTATIN 10MG TAB (HEA) 3X10 A 0.087 10MG 30 2024-04-01 2026-03-31 6
41 1132HM XTOR 20MG TAB (IPC) ATORVASTATIN 100'S A 0.0468 20MG 30 2024-04-01 2026-03-31 6
41 1132HN ATORVASTATIN 20MG TAB (GPC) 30'S A 0.0526 20MG 30 2024-04-01 2026-03-31 6
41 1132HV RSTAT 10MG TAB (TPP) ROSUVASTATIN 10X10 A 0.0495 10MG 30 2024-04-01 2026-03-31 6
42 1132HV RSTAT 10MG TAB (TPP) ROSUVASTATIN 10X10 A 0.05 10MG 30 2026-04-01 No No 6
42 1132JE STALIP 20MG TAB (STL) ATORVASTATIN 30'S A 0.04 20MG 30 2026-04-01 No No 6
42 1132JF LIPITOR 20MG TAB (PFI) ATORVASTATI (C) 3X10 C 1.22 20MG 30 2026-04-01 No No 6
42 1132JP ROSELLION 10MG TAB (STL) ROSUVASTATIN 3X10 A 0.04 10MG 30 2026-04-01 No No 6
42 1132JT ATORVASTATIN 20MG TAB (MOR) 30'S A 0.05 20MG 30 2026-04-01 No No 6
42 1132KH FLAGTOR 20MG TAB (FSB) ATORVASTATIN 10X10 A 0.01 20MG 30 2026-04-01 No No Add to Contract as Cat A 6
42 1132KM ATOREM 20MG TAB (MSN) ATORVASTATIN 3X10 A 0.05 20MG 30 2026-03-24 No No Add to Contract as Cat A 6
40 1133AQ ATORVASTATIN 40MG TAB (CPP/COL) 28'S A 0.09 40MG 60 2022-04-01 2024-03-31 6