Displaying 821 - 840 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 1162AB HYDRALLAZINE 50MG TAB (FSB) 10X10 A 0.08 50MG 60 2026-04-01 No No Add to Contract as Cat A 6
40 1162T HYDRALLAZINE 50MG TAB (FSB/ATB) 25X10 A 0.13 50MG 60 2022-04-01 2024-03-31 6
41 11637 HYDRALLAZINE 20MG/ML INJ (FSB) (B) 20MG VIAL B 38.1109 20MG/ML 0 2024-04-01 2026-03-31 0
40 1163H HYDRALLAZINE 20MG/ML INJ (MON/PHA) 10X1ML B 4.32 20MG/ML 0 2022-04-01 2024-03-31 0
40 1163J LAHYZINE 20MG/ML INJ (LDP/AHI) HYDRALLAZINE 20MG VIAL B 5.71 20MG/ML 0 2022-04-01 2024-03-31 0
41 1163K HYDRALLAZINE 20MG/ML INJ (DIL) (B) 25X1ML B 37.5498 20MG/ML 0 2024-04-01 2026-03-31 0
40 1171V ALDOMET 250MG TAB (ASG/STO) METHYLDOPA 30'S A 0.18 250MG 180 2022-04-01 2024-03-31 6
41 1171V ALDOMET 250MG TAB (ASG) METHYLDOPA 30'S A 0.3878 250MG 180 2024-04-01 2026-03-31 6
42 1171V ALDOMET 250MG TAB (ASG) METHYLDOPA 30'S A 0.46 250MG 180 2026-04-01 No No 6
40 1172K ALDOMET 500MG TAB (ASG/STO) METHYLDOPA 30'S A 0.29 500MG 180 2022-04-01 2024-03-31 6
41 1172K ALDOMET 500MG TAB (ASG) METHYLDOPA 30'S A 0.6343 500MG 180 2024-04-01 2026-03-31 6
42 1172K ALDOMET 500MG TAB (ASG) METHYLDOPA 30'S A 0.74 500MG 180 2026-04-01 No No 6
40 11816 CONCOR 2.5MG TAB (MEK/COL) BISOPROLOL 30'S C 0.96 2.5MG 0 2022-04-01 2024-03-31 0
41 11816 CONCOR 2.5MG TAB (MEK) BISOPROLOL (C) 30'S C 0.9605 2.5MG 30 2024-04-01 2026-03-31 6
42 11816 CONCOR 2.5MG TAB (MEK) BISOPROLOL 30'S C 1.01 2.5MG 30 2026-04-01 No No 6
40 1181AJ APO-SOTALOL 80MG TAB (APO/COL) 100'S A 0.11 80MG 90 2022-04-01 2024-03-31 6
42 1181AJ APO-SOTALOL 80MG TAB (APO) 100'S A 0.11 80MG 90 2026-04-01 No No 6
41 1181CF PMS-SOTALOL 80MG TAB (PMS) 100'S A 0.1767 80MG 90 2024-04-01 2026-03-31 6
40 1181EF BISOPROLOL 2.5MG TAB (FSB/ATB) 10X10 A 0.04 2.5MG 30 2022-04-07 2022-09-30 6
40 1181EV CILENOL 2.5MG TAB (CIR/AHI) BISOPROLOL 30'S A 0.09 2.5MG 30 2022-04-01 2022-09-30 6