Displaying 1 - 20 of 20
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 A7318 ELEVE 0.1% EYE DR (ASL/PHA) OLOPATADINE 5ML A 6.96 0.1% 1 2022-04-01 2024-03-31 6
41 A7318 ELEVE 0.1% EYE DR (ASL) OLOPATADINE (C) 5ML C 8.4812 0.1% 1 2024-04-01 2026-03-31 6
42 A7318 ELEVE 0.1% EYE DR (ASL) OLOPATADINE 5ML A 7.64 0.1% 1 2026-04-01 No No 6
40 A7319 OLPADIN 0.1% EYE DR (ARP/AHI) OLOPATADINE 5ML A 6.06 0.1% 1 2022-04-01 2024-03-31 6
40 A731C PATANOL 0.1% EYE DR (NVS/COL) OLOPATADINE 5ML C 26.67 0.1% 0 2022-04-01 2024-03-31 0
41 A731C PATANOL 0.1% EYE DR (NVS) OLOPATADI (C) 5ML C 26.6668 0.1% 1 2024-04-01 2026-03-31 6
42 A731C PATANOL 0.1% EYE DR (NVS) OLOPATADI 5ML C 26.50 0.1% 1 2026-04-01 No No 6
42 A731E OLOPLUS 0.1% EYE DR (SHC) OLOPATADINE 5ML A 5.65 0.1% 1 2026-04-01 No No 6
41 A731F LOPADIN 0.1% EYE DR (INC) OLOPATADINE 5ML A 5.7085 0.1% 1 2024-04-01 2026-03-31 6
42 A731F LOPADIN 0.1% EYE DR (INC) OLOPATADINE 5ML A 5.71 0.1% 1 2026-04-01 No No 6
41 A731G OLOPATADINE 0.1% EYE DR (FSB) 5ML A 5.7628 0.1% 1 2024-04-01 2026-03-31 6
40 A7328 KUARA 0.2% EYE DR (LPO/COL) OLOPATADINE 3ML A 8.15 0.2% 1 2022-04-01 2024-03-31 6
41 A7328 KUARA 0.2% EYE DR (LPO) OLOPATADINE 3ML A 8.15 0.2% 1 2024-04-01 2025-01-30 6
40 A732B OLOPATADINE 0.2% EYE DR (CIR/AHI) 5ML A 9.27 0.2% 1 2022-04-01 2024-03-31 6
40 A732H PATADAY 0.2% EYE DR (NVS/COL) OLOPATADINE 2.5ML C 25.36 0.2% 0 2022-04-01 2024-03-31 0
41 A732H PATADAY 0.2% EYE DR (NVS) OLOPATADI (C) 2.5ML C 25.362 0.2% 1 2024-04-01 2026-03-31 6
42 A732H PATADAY 0.2% EYE DR (NVS) OLOPATADI 2.5ML C 25.36 0.2% 1 2026-04-01 No No 6
42 A732J OLOPLUS OD 0.2% EYE DR (SHC) OLOPATADINE 3ML B 8.21 0.2% 1 2026-04-01 No No 6
42 A732K LOPADIN 0.2% EYE DR (INC) OLOPATADINE 5ML A 3.53 0.2% 1 2026-04-01 No No 6
41 A732L OLOPATADINE 0.2% EYE DR (FSB) 2.5ML A 7.5841 0.2% 1 2024-04-01 2026-03-31 6