Displaying 1 - 15 of 15
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 43314 GLIVEC 100MG CAP (NVS/COL) IMATINIB 60'S C 41.31 100MG 0 2022-04-01 2024-03-31 0
41 43314 GLIVEC 100MG CAP (NVS) IMATINIB (BQ) 60'S BQ 41.3067 100MG 120 2024-04-01 2026-03-31 6
42 43314 GLIVEC 100MG CAP (NVS) IMATINIB 60'S BQ 41.31 100MG 120 2026-04-01 No No 0
40 4331AA APO-IMATINIB 100MG TAB (APO/COL) 30'S BQ 1.13 100MG 0 2022-04-01 2024-03-31 6
42 4331AD IMATINIB DENK 100MG TAB (EDK) 30'S BQ 43.04 100MG 120 2026-04-01 No No 0
41 4331BA APO-IMATINIB 100MG TAB (APO) IMATIN (BQ) 30'S BQ 1.1508 100MG 120 2024-04-01 2026-03-31 0
41 4331BB ZIMITIB 100MG CAP (ZUV) IMATINIB (BQ) 120'S BQ 0.5147 100MG 120 2024-04-01 2024-05-17 6
41 4331BD ZIMITIB 100 CAP (ZUV) IMATINIB 30'S BQ 1.5893 100 2024-04-05 2026-03-31
40 43321 GLIVEC 400MG CAP (NVS/COL) IMATINIB 30'S C 153.31 400MG 0 2022-04-01 2024-03-31 0
41 43321 GLIVEC 400MG CAP (NVS) IMATINIB (SAD) (BQ) 30'S BQ 152.2914 400MG 60 2024-04-01 2026-03-31 6
42 43321 GLIVEC 400MG CAP (NVS) IMATINIB (SAD) 30'S C 152.29 400MG 60 2026-04-01 No No 6
42 43327 IMATINIB 400MG CAP (ZUV) 30'S BQ 1.07 400MG 60 2026-04-01 No No 0
40 4332K APO-IMATINIB 400MG TAB (APO/COL) 30'S BQ 4.13 400MG 0 2022-04-01 2024-03-31 6
41 4332U TYKONIB 400MG TAB (MSN) (BQ) 30'S BQ 3.9008 400MG 60 2024-04-01 2026-03-31 6
41 4332Y APO-IMATINIB 400MG CAP (APO) (BQ) 30'S BQ 4.1735 400MG 60 2024-04-01 2026-03-31 6