Displaying 1 - 20 of 23
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 A2313 NEURONTIN 300MG CAP (PFI/STO) GABAPENTIN 100'S C 1.50 300MG 0 2022-04-01 2024-03-31 0
41 A2313 NEURONTIN 300MG CAP (PFI) GABAPENTIN (C) 100'S C 1.5144 300MG 180 2024-04-01 2026-03-31 6
40 A2314 APO-GABAPENTIN 300MG CAP (APO/COL) 100'S A 0.12 300MG 180 2022-04-01 2024-03-31 6
42 A2314 APO-GABAPENTIN 300MG CAP (APO) 100'S C 0.13 300MG 180 2026-04-01 No No 6
42 A231AE GABAPENTIN 300MG CAP (FSB) 100'S A 0.07 300MG 180 2026-04-01 No No Add to Contract as Cat A 6
40 A231AG GABAPENTIN 300MG CAP (KWA/ATB) 10X10 A 0.12 300MG 180 2022-04-01 2024-03-31 6
41 A231AY GABAPENTIN 300MG CAP (FSB) 100'S A 0.0818 300MG 180 2024-04-01 2026-03-31 6
42 A231B GABANIL 300MG CAP (REM) GABAPENTIN 5X10 C 0.18 300MG 180 2026-04-01 No No 6
40 A231BE GABAPENTIN 300MG CAP (AUR/AHI) 100'S A 0.12 300MG 180 2022-04-01 2024-03-31 Price Change 6
41 A231BG APO-GABAPENTIN 300MG CAP (APO) 100'S A 0.097 300MG 180 2024-04-01 2026-03-31 6
41 A231BL GABAPENTIN 300MG CAP (MCP) 10X10 A 0.0924 300MG 180 2024-04-01 2026-03-31 6
42 A231BL GABAPENTIN 300MG CAP (MCP) 10X10 A 0.09 300MG 180 2026-04-01 No No 6
42 A231BP NEURONTIN 300MG CAP (PFI) GABAPENTIN 100'S C 1.51 300MG 180 2026-04-01 No No 6
42 A231BQ GABALGIA 300MG CAP (ANC) GABAPENTIN 10X10 A 0.07 300MG 180 2026-04-01 No No 6
40 A231D NEURONTIN 300MG CAP (PFI/SBI) GABAPENTIN 100'S C 1.50 300MG 0 2022-04-01 2024-03-31 0
41 A231D NEURONTIN 300MG CAP (PFI) GABAPENTIN (C) 100'S C 1.5144 300MG 180 2024-04-01 2026-03-31 6
40 A231H GABANIL 300MG CAP (REM/SBI) GABAPENTIN 5X10 C 0.19 300MG 0 2022-04-01 2024-03-31 0
40 A2324 APO-GABAPENTIN 100MG CAP (APO/COL) 100'S C 0.10 100MG 0 2022-04-01 2024-03-31 0
42 A2324 APO-GABAPENTIN 100MG CAP (APO) 100'S C 0.10 100MG 0 2026-04-01 No No 0
41 A232P APO-GABAPENTIN 100MG CAP (APO) (C) 100'S C 0.097 100MG 0 2024-04-01 2026-03-31 0