Displaying 801 - 820 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 1134BD ATORVASTATIN 80MG TAB (MOR) 30'S A 0.10 80MG 30 2026-04-01 No No 6
41 1134W ATORVASTATIN 80MG TAB (FSB) 10X10 A 0.1359 80MG 30 2024-04-01 2026-03-31 6
40 1134Y CRESTOR 40MG TAB (AZN/COL) ROSUVASTATIN 30'S C 1.54 40MG 0 2022-04-01 2024-03-31 0
41 1134Y CRESTOR 40MG TAB (AZN) ROSUVASTATIN (C) 30'S C 1.5413 40MG 30 2024-04-01 2026-03-31 6
42 1134Y CRESTOR 40MG TAB (AZN) ROSUVASTATIN 30'S C 1.54 40MG 30 2026-04-01 No No 6
41 11519 GEMFIBROZIL 300MG TAB (KWA) 100'S A 0.2718 300MG 60 2024-04-01 2026-03-31 6
42 1151B TRILIPIX 135MG DR CAP (ABB) FENOFIBRATE 3X10 C 2.99 135MG 0 2026-04-01 No No 0
40 11529 GEMFIBROZIL 600MG TAB (CIP/AHI) 60'S B 0.68 600MG 60 2022-04-01 2024-03-31 6
41 11529 GEMFIBROZIL 600MG TAB (CIP) 60'S B 0.6809 600MG 60 2024-04-01 2026-03-31 6
42 11529 GEMFIBROZIL 600MG TAB (CIP) 60'S C 0.68 600MG 60 2026-04-01 No No 6
40 11613 HYDRALLAZINE 25MG TAB (REM/SBI) 10X10 A 0.06 25MG 120 2022-04-01 2024-03-31 6
41 11613 HYDRALLAZINE 25MG TAB (REM) 10X10 A 0.0707 25MG 120 2024-04-01 2026-03-31 6
40 11615 APO-HYDRALLAZINE 25MG TAB (APO/COL) 100'S A 0.07 25MG 120 2022-04-01 2024-03-31 6
42 11615 APO-HYDRALLAZINE 25MG TAB (APO) 100'S A 0.06 25MG 120 2026-04-01 No No 6
41 1161AA HYDRALLAZINE 25MG TAB (LDP) 250'S A 0.0595 25MG 120 2024-04-01 2026-03-31 6
41 1161AC APO-HYDRALLAZINE 25MG TAB (APO) 100'S A 0.0642 25MG 120 2024-04-01 2026-03-31 6
42 1161AD HYDRALLAZINE 25MG TAB (FSB) 10X10 A 0.06 25MG 120 2026-04-01 No No Add to Contract as Cat A 6
40 11625 APO-HYDRALLAZINE 50MG TAB (APO/COL) 100'S A 0.17 50MG 60 2022-04-01 2024-03-31 6
42 11625 APO-HYDRALLAZINE 50MG TAB (APO) 100'S A 0.13 50MG 60 2026-04-01 No No 6
41 1162AA APO-HYDRALAZINE 50MG TAB (APO) 100'S A 0.1332 50MG 60 2024-04-01 2026-03-31 6