Displaying 1 - 20 of 66
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 11311 APO-ATORVASTATIN 10MG TAB (APO/COL) 100'S A 0.05 10MG 30 2022-04-01 2024-03-31 6
40 1131AY ATORVASTATIN 10MG TAB (CPP/COL) 28'S A 0.04 10MG 30 2022-04-01 2024-03-31 6
40 1131CZ LIPITOR 10MG TAB (PFI/STO) ATORVASTATIN 30'S C 1.11 10MG 0 2022-04-01 2024-03-31 0
41 1131CZ LIPITOR 10MG TAB (PFI) ATORVASTATIN (C) 30'S C 1.1163 10MG 30 2024-04-01 2026-03-31 6
40 1131DA LIPITOR 10MG TAB (PFI/SBI) ATORVASTATIN 30'S C 1.11 10MG 0 2022-04-01 2024-03-31 0
41 1131DA LIPITOR 10MG TAB (PFI) ATORVASTATIN (C) 30'S C 1.1163 10MG 30 2024-04-01 2026-03-31 6
40 1131DQ ATOREC 10MG TAB (EMC/COL) ATORVASTATIN 30'S C 0.11 10MG 0 2022-04-01 2024-03-31 0
42 1131DQ ATOREC 10MG TAB (EMC) ATORVASTATIN (C) 30'S C 0.12 10MG 30 2026-04-01 No No 6
41 1131DW ATORSTAN 10MG TAB (REM) ATORVASTATI 3x10 A 0.0535 10MG 30 2024-04-01 2024-06-30 6
41 1131DW ATORSTAN 10MG TAB (REM) ATORVASTATI 3x10 A 0.1593 10MG 30 2024-08-07 2024-09-18 6
42 1131DW ATORSTAN 10MG TAB (REM) ATORVASTAT (C) 3x10 C 0.11 10MG 30 2026-04-01 No No 6
41 1131FA ATOREM 10MG TAB (MSN) ATORVASTATIN 3X10 A 0.0399 10MG 30 2024-04-01 2026-03-31 6
40 1131FK ATORVASTATIN 10MG TAB (UME/AHI) 3X10 A 0.05 10MG 30 2022-04-01 2024-03-31 6
41 1131FN ATORVASTATIN 10MG TAB (TPP) 10X10 A 0.0386 10MG 30 2024-04-01 2026-03-31 6
42 1131FN ATORVASTATIN 10MG TAB (TPP) 10X10 A 0.04 10MG 30 2026-04-01 No No 6
40 1131FW LIPITAS 10MG TAB (INP/AHI) ATORVASTATIN 30'S A 0.1187 10MG 2023-03-20 2024-03-31 No No Add to Contract as Cat A 6
41 1131FZ XTOR 10MG TAB (IPC) ATORVASTATIN 100'S A 0.0397 10MG 30 2024-04-01 2026-03-31 6
41 1131GT ATORVASTATIN 10MG TAB (INP) 1000'S A 0.036 10MG 30 2024-04-01 2026-03-31 6
42 1131GW STALIP 10MG TAB (STL) ATORVASTATIN 30'S A 0.02 10MG 30 2026-04-01 No No 6
42 1131GX LIPITOR 10MG TAB (PFI) ATORVASTATI (C) 3X10 C 1.12 10MG 30 2026-04-01 No No 6