Displaying 1701 - 1720 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 2451AP ALKA AD 2MG TAB (BSP/COL) LOPERAMIDE 12'S C 0.30 2MG 0 2022-04-01 2024-03-31 0
41 2451AQ LOPERAMIDE 2MG CAP (TEV) 30'S A 0.0988 2MG 30 2024-04-01 2024-12-16 6
41 2451AQ LOPERAMIDE 2MG CAP (TEV) 30'S A 0.1523 2MG 30 2024-12-17 2026-03-31 6
41 2451AT ALKA AD 2MG TAB (BSP) LOPERAMIDE (C) 72'S C 0.2548 2MG 30 2024-04-01 2026-03-31 6
41 2451AV ALKA AD 2MG TAB (BSP) LOPERAMIDE (C) 72'S C 0.2548 2MG 30 2024-04-01 2026-03-31 6
42 2451AV ALKA AD 2MG TAB (BSP) LOPERAMIDE 72'S A 0.23 2MG 30 2026-04-01 No No 6
40 2451U IMODIUM 2MG TAB (JAC/STO) LOPERAMIDE 60'S C 1.11 2MG 0 2022-04-01 2022-05-24 Delete from contract 0
42 2451Y PMS-LOPERAMIDE 2MG CAP (PMS) 100'S A 0.16 2MG 30 2026-04-01 No No 6
40 2471F APO-LITHIUM CARB. 300MG CAP (APO/COL) 100'S A 0.14 300MG 120 2022-04-01 2024-03-31 6
41 2471T APO-LITHIUM CARB. 300MG CAP (APO) 100'S A 0.1405 300MG 120 2024-04-01 2026-03-31 6
40 2491AD DEXAMETHASONE SODIUM PHOSPHATE 4MG/ML IV/IM INJ (RTM/PHA) 10X1ML B 1.09 4MG/ML IV/IM 0 2022-04-01 2024-03-31 0
41 2491AD DEXAMET. SOD. PHOS. 4MG/ML IV/IM INJ (RTM) 10X1ML BQ 1.4924 4MG/ML IV/IM 0 2024-04-01 2026-03-31 0
42 2491AD DEXAMET. SOD. PHOS. 4MG/ML IV/IM INJ (RTM) 10X1ML B 1.25 4MG/ML IV/IM 0 2026-04-01 No No 0
41 2491AR DEXAMET. SOD. PHOS. 4MG/ML IV/IM INJ (KR (B) 25X1ML B 0.6524 4MG/ML IV/IM 0 2024-04-01 2026-03-31 0
41 24922 DEXAMET. SOD. PHOS. 10MG/ML IV/IM INJ (OMG) DEXAMETHASONE SO (B) 10X1ML B 4.7353 10MG/ML IV/IM 0 2024-04-01 2026-03-31 0
42 24922 DEXAMET. SOD. PHOS. 10MG/ML IV/IM INJ (OMG) DEXAMETHASONE SO 10X1ML B 7.61 10MG/ML IV/IM 0 2026-04-01 No No 0
40 2511AV KONSYL ORGANIC SF PWDR (KSY/COL) PSYLLIUM 340G C 48.93 0 2022-04-01 2024-03-31 0
40 2511AW KONSYL DAILY SF PWDR (KSY/COL) PSYLLIUM 402G A 32.86 1 2022-04-01 2024-03-31 6
40 2511AX KONSYL ORIGINAL PWDR (KSY/COL) PSYLLIUM 300G A 27.18 1 2022-04-01 2024-03-31 6
41 2511AX KONSYL ORIGINAL PWDR (KSY) PSYLLIU 300G A 29.4666 6G 1 2024-04-01 2026-03-31 6