Displaying 1901 - 1920 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
41 2791D OVESTIN 1MG VAG CR (ASG) ESTRIOL 15G A 41.9981 1MG 1 2024-04-01 2026-03-31 6
42 2791D OVESTIN 1MG VAG CR (ASG) ESTRIOL 15G A 45.80 1MG 1 2026-04-01 No No 6
41 27921 OVESTIN 0.5MG OV (ASG) ESTRIOL 15'S A 41.9981 0.5MG 1 2024-04-01 2026-03-31 6
42 27921 OVESTIN 0.5MG OV (ASG) ESTRIOL 15'S A 3.05 0.5MG 15 2026-04-01 No No Amend Protocol Quantity 6
40 2831AG AMARYL 2MG TAB (SFA/COL) GLIMEPIRIDE 15'S C 0.18 2MG 0 2022-04-01 2024-03-31 0
41 2831AG AMARYL 2MG TAB (SFA) GLIMEPIRIDE (C) 15'S C 0.2718 2MG 45 2024-04-01 2026-03-31 6
40 2831FJ DAONIL 5MG TAB (SFA/COL) GLIBENCLAMIDE 100'S A 0.11 5MG 120 2022-04-01 2024-03-31 6
40 2831GP GLIMEPIRIDE 2MG TAB (DRL/AHI) 100'S C 0.13 2MG 0 2022-04-01 2024-03-31 0
41 2831GT GLITISOL 5MG TAB (REM) GLIBENCLAMIDE 40'S A 0.0537 5MG 120 2024-04-01 2026-03-31 6
42 2831GV GETRYL 2MG TAB (GET) GLIMEPIRIDE 20'S C 0.05 2MG 45 2026-04-01 No No 6
42 2831HD GLIFORD 5MG TAB (JLP) GLIBENCLAMIDE 200'S A 0.05 5MG 120 2026-04-01 No No 6
40 28321 DIAMICRON MR 60MG TAB (SER/STO) GLICLAZIDE 30'S A 0.24 60MG 60 2022-04-01 2024-03-31 contract extended 6
40 2832AT DIAMICROM MR 60MG TAB (SER/COL) GLICLAZIDE 30'S A 0.24 60MG 60 2022-04-01 2024-03-31 Contract Extended 6
40 2832BA AMARYL 4MG TAB (SFA/COL) GLIMEPIRIDE 15'S C 0.27 4MG 0 2022-04-01 2024-03-31 0
41 2832BA AMARYL 4MG TAB (SFA) GLIMEPIRIDE (C) 15'S C 0.2718 4MG 60 2024-04-01 2026-03-31 6
40 2832BP GLICLAZIDE MR 60MG TAB (SER/COL) 30'S A 0.24 60MG 60 2022-04-01 2024-03-31 Name Change 6
40 2832BP GLICLAZIDE MR 60MG TAB (SER/COL) 30'S A 0.24 60MG 60 2022-04-01 2024-03-31 Name Change 6
41 2832BP GLICLAZIDE MR 60MG TAB (SER) 30'S A 0.2465 60MG 60 2024-04-01 2026-03-31 6
42 2832BP GLICLAZIDE MR 60MG TAB (SER) 30'S A 0.25 60MG 60 2026-04-01 No No 6
41 2832BQ GLICLAZIDE MR 60MG TAB (SER) 30'S A 0.2465 60MG 60 2024-04-01 2026-03-31 6