Displaying 1 - 6 of 6
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
42 B041EV APO-LANSOPRAZOLE 15MG CAP (APO) 100'S C 0.13 15MG 0 2026-04-01 No No 0
40 B041EW APO-LANSOPRAZOLE 30MG CAP (APO/COL) 100'S C 0.20 30MG 0 2022-04-01 2024-03-31 0
42 B041EW APO-LANSOPRAZOLE 30MG CAP (APO) 100'S C 0.20 30MG 0 2026-04-01 No No 0
41 B041NP APO-LANSOPRAZOLE 15MG CAP (APO) (C) 100'S C 0.1068 15MG 0 2024-04-01 2026-03-31 0
41 B041NT APO-LANSOPRAZOLE 30MG CAP (APO) (C) 100'S C 0.2031 30MG 0 2024-04-01 2026-03-31 0
42 B041QD JUNIOR LANZOL 15MG CHEW TAB (CIP) LANSOPRAZOLE 120'S C 0.67 15MG 0 2026-04-01 No No 0