Displaying 1281 - 1300 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 1664A APO-OLANZAPINE 10MG TAB (APO) 100'S BP 0.30 10MG 42 2026-04-01 No No 0
40 1664U OLANZAPINE 10MG TAB (MCP/AHI) 30'S BP 0.19 10MG 0 2022-04-01 2024-03-31 6
41 1664U OLANZAPINE 10MG TAB (MCP) (BP) 30'S BP 0.1975 10MG 42 2024-04-01 2026-03-31 6
41 1664Z APO-OLANZAPINE 10MG TAB (APO) (BP) 100'S BP 0.3028 10MG 42 2024-04-01 2026-03-31 6
40 16715 PERPHENAZINE 4MG TAB (KWA/ATB) 50X10 A 1.36 4MG 180 2022-04-01 2022-09-30 6
40 16716 AAP-PERPHENAZINE 4MG TAB (APO/COL) PERPHENAZI 100'S A 0.41 4MG 180 2022-04-01 2024-03-31 6
42 16716 AAP-PERPHENAZINE 4MG TAB (APO) PERP 100'S A 0.42 4MG 180 2026-04-01 No No 6
41 16717 AAP-PERPHENAZINE 4MG TAB (APO) PERP 100'S A 0.4159 4MG 180 2024-04-01 2026-03-31 6
40 16814 STEMETIL 5MG TAB (SFA/COL) PROCHLORPER 25'S C 0.51 5MG 0 2022-04-01 2024-03-31 0
40 16819 CARMETIC 5MG TAB (CAR/COL) PROCHLORPERAZINE 1000'S A 0.07 5MG 180 2022-04-01 2024-03-31 6
41 16819 CARMETIC 5MG TAB (CAR) PROCHLORPERAZINE 1000'S A 0.0718 5MG 180 2024-04-01 2026-03-31 6
42 16819 CARMETIC 5MG TAB (CAR) PROCHLORPERAZINE 1000'S A 0.07 5MG 180 2026-04-01 No No 6
41 1691B THIORIDAZINE 10MG TAB (MAT) 100'S A 2.219 10MG 360 2024-04-01 2026-03-31 6
42 1691B THIORIDAZINE 10MG TAB (MAT) 100'S A 2.22 10MG 360 2026-04-01 No No 6
41 1692M THIORIDAZINE 25MG TAB (MAT) 100'S A 3.1206 25MG 360 2024-04-01 2026-03-31 6
42 1692M THIORIDAZINE 25MG TAB (MAT) 100'S A 3.12 25MG 360 2026-04-01 No No 6
42 1693C THIORIDAZINE 50MG TAB (MAT) 1000'S A 0.36 50MG 300 2026-04-01 No No 6
41 17015 TRIFLUOPERAZINE 1MG TAB (GPC) 1000'S A 0.0177 1MG 252 2024-04-01 2026-03-31 6
42 17016 TRIFLUOPERAZINE 1MG TAB (MAT) 1000'S A 0.15 1MG 252 2026-04-01 No No 6
40 17025 TRIFLUOPERAZINE 5MG TAB (REM/SBI) 1000'S A 0.06 5MG 180 2022-04-01 2024-03-31 6