Displaying 1 - 20 of 60
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 4141KJ DICLOFENAC SOD 50MG TAB (HEA/RXP) 10X10 A 0.03 50MG 42 2022-04-01 2024-03-31 6
40 4141KW VOLTAREN 50MG TAB (NVS/COL) DICLOFENAC SOD 100'S C 0.92 50MG 0 2022-04-01 2024-03-31 0
41 4141KW VOLTAREN 50MG TAB (NVS) DICLOFENAC SOD (C) 100'S C 0.9231 50MG 42 2024-04-01 2026-03-31 6
42 4141KW VOLTAREN 50MG TAB (NVS) DICLOFENAC SODIUM 100'S C 0.92 50MG 42 2026-04-01 No No 6
41 4141RE DICLOFENAC 50MG TAB (HEA) 10X10 A 0.0269 50MG 42 2024-04-01 2026-03-31 6
41 4141RM APO-DICLOFENAC SODIUM 25MG TAB (APO) 100'S A 0.1079 25MG 100 2024-04-01 2026-03-31 6
42 4141SU DICLOFENAC SODIUM 50MG TAB (HEA) 10X10 A 0.03 50MG 42 2026-04-01 No No Price Change 6
42 4141TJ DICLOFENAC SODIUM 50MG TAB (HEA) 10X10 A 0.03 50MG 42 2026-04-01 No No Add to Contract as Cat A 6
42 4141TL DICLOFENAC 50MG TAB (HEA) 10X10 A 0.03 50MG 42 2026-04-01 No No Add to Contract as Cat A 6
40 4141TV DICLOFENAC SOD 50MG TAB (HEA/ATB) 10X10 A 0.0264 50MG 2022-12-07 2024-03-31 No No Change Local Agent 6
40 4141ZJ APO-DICLO 25MG TAB (APO/COL) 100'S A 0.10 25MG 100 2022-04-01 2024-03-31 6
42 4141ZJ APO-DICLO 25MG TAB (APO) 100'S A 0.09 25MG 100 2026-04-01 No No 6
40 41421 VOLTAREN 25MG/ML IV/IM INJ (NVS/COL) DICLOFEN 5X3ML C 4.20 25MG/ML IV/IM 0 2022-04-01 2024-03-31 0
41 41421 VOLTAREN 25MG/ML IV/IM INJ (NVS) DICLOFE (C) 5X3ML C 4.1971 25MG/ML IV/IM 0 2024-04-01 2026-03-31 0
42 41421 VOLTAREN 25MG/ML IV/IM INJ (NVS) DICLOFE 5X3ML C 4.20 25MG/ML IV/IM 0 2026-04-01 No No 0
40 4142AY DICLOFENAC SOD 25MG/ML IV/IM INJ (MON/PHA) 10X3ML B 0.61 25MG/ML IV/IM 0 2022-04-01 2024-03-31 0
41 4142BL DICLOFENAC SOD 25MG/ML IV/IM INJ (C (B) 10X3ML B 0.3996 25MG/ML IV/IM 0 2024-04-01 2026-03-31 0
42 4142BM DICLOFENAC SODIUM 25MG/ML INJ (BAX) 10X3ML B 0.34 25MG/ML IV/IM 0 2026-04-01 No No 0
42 4142BR DICLOFENAC SODIUM 25MG/ML IV/IM INJ (MON) 10X3ML B 0.22 25MG/ML IV/IM 0 2026-04-01 No No 0
42 4142BT NACKDOL 25MG/ML INJ (JLP) DICLOFENAC SODIUM 50X3ML B 0.22 25MG/ML IV/IM 0 2026-04-01 No No 0