Displaying 1 - 18 of 18
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 A6711 SINGULAIR 5MG TAB (MSD/STO) MONTELUKAST 30'S C 1.58 5MG 0 2022-04-01 2024-03-31 0
41 A6711 SINGULAIR 5MG TAB (MSD/STO) MONTELUKAST (C) 30'S C 1.592 5MG 30 2024-04-01 2026-03-31 6
40 A6712 SINGULAIR 10MG TAB (MSD/STO) MONTELUKAST 30'S C 1.58 10MG 0 2022-04-01 2024-03-31 0
41 A6712 SINGULAIR 10MG TAB (MSD) MONTELUKAST (C) 30'S C 1.592 10MG 30 2024-04-01 2026-03-31 6
40 A6715 SINGULAIR 4MG TAB (MSD/STO) MONTELUKAST 30'S C 1.58 4MG 0 2022-04-01 2024-03-31 0
41 A6715 SINGULAIR 4MG TAB (MSD) MONTELUKAST (C) 30'S C 1.592 4MG 30 2024-04-01 2026-03-31 6
40 A671AA APO-MONTELUKAST 10MG TAB (APO/COL) 30'S A 0.19 10MG 30 2022-04-01 2024-03-31 6
40 A671AY BREATHEZY CHEWABLE 5MG TAB (MSN/AHI) MONTELUK 3X10 A 0.10 5MG 30 2022-04-01 2022-09-30 6
40 A671AZ BREATHEZY CHEWABLE 4MG TAB (MSN/AHI) MONTELUK 3X10 A 0.09 4MG 30 2022-04-01 2022-09-30 6
40 A671BA BREATHEZY 10MG TAB (MSN/AHI) MONTELUKAST 3X10 A 0.18 10MG 30 2022-04-01 2022-09-30 6
41 A671CB BREATHEZY 10MG TAB (MSN) MONTELUKAS 3X10 A 0.1758 10MG 30 2024-04-01 2026-03-31 6
40 A671CE MONTELUKAST CHEWABLE 10MG TAB (TOR/AHI) MONTE 90'S A 0.16 10MG 30 2022-04-01 2024-03-31 6
41 A671CJ APO-MONTELUKAST CHEWABLE 4MG TAB (A 30'S A 0.1223 4MG 30 2024-04-01 2026-03-31 6
41 A671CK APO-MONTELUKAST 10MG TAB (APO) MONT 30'S A 0.1676 10MG 30 2024-04-01 2026-03-31 6
41 A671CL APO-MONTELUKAST CHEWABLE 5MG TAB (A 30'S A 0.1314 5MG 30 2024-04-01 2026-03-31 6
41 A671K PMS-MONTELUKAST CHEWABLE 4MG TAB (PMS) 100'S A 0.1414 4MG 30 2024-04-01 2026-03-31 6
40 A671V APO-MONTELUKAST CHEWABLE 4MG TAB (APO/COL) 30'S A 0.12 4MG 30 2022-04-01 2024-03-31 6
40 A671W APO-MONTELUKAST CHEWABLE 5MG TAB (APO/COL) 30'S A 0.13 5MG 30 2022-04-01 2024-03-31 6