Displaying 1 - 12 of 12
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 39216 PLAVIX 75MG TAB (SFA/COL) CLOPIDOGREL 28'S C 2.91 75MG 0 2022-04-01 2024-03-31 0
41 39216 PLAVIX 75MG TAB (SFA) CLOPIDOGREL (C) 28'S C 2.9125 75MG 30 2024-04-01 2026-03-31 6
42 39216 PLAVIX 75MG TAB (SFA) CLOPIDOGREL 28'S C 2.91 75MG 30 2026-04-01 No No 6
40 3921BS CLOPIDOGREL 75MG TAB (KWA/ATB) 100'S A 0.08 75MG 30 2022-04-01 2024-03-31 6
40 3921CK PLASEP 75MG TAB (MSN/ATB) CLOPIDOGREL 3X10 A 0.06 75MG 30 2022-04-01 2022-07-26 6
40 3921CK PLASEP 75MG TAB (MSN/ATB) CLOPIDOGREL 3X10 A 0.07 75MG 30 2022-09-06 2024-03-31 Price Change 6
41 3921CK PLASEP 75MG TAB (MSN) CLOPIDOGREL 3X10 A 0.0879 75MG 30 2024-04-01 2026-03-31 6
41 3921DM CLOPIDOGREL 75MG TAB (MCP) 10X10 A 0.0693 75MG 30 2024-04-01 2026-03-31 6
42 3921ER PLASEP 75MG TAB (MSN) CLOPIDOGREL 3X10 A 0.08 75MG 30 2026-04-01 No No Add to Contract as Cat A 6
40 3921K ANTIPLAR 75MG TAB (EMC/COL) CLOPIDOGREL 100'S A 0.10 75MG 30 2022-05-31 2022-12-31 6
41 3921K ANTIPLAR 75MG TAB (EMC) CLOPIDOGREL 100'S A 0.087 75MG 30 2024-04-01 2026-03-31 6
42 3921K ANTIPLAR 75MG TAB (EMC) CLOPIDOGREL 100'S A 0.09 75MG 30 2026-04-01 No No 6