Displaying 1 - 12 of 12
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 B041AU ALOCID 20MG CAP (CAR/COL) OMEPRAZOLE 3X10 C 0.18 20MG 0 2022-04-01 2024-03-31 0
41 B041AU ALOCID 20MG CAP (CAR) OMEPRAZOLE (C) 3X10 C 0.1812 20MG 30 2024-04-01 2026-03-31 6
40 B041EL OMEPRAZOLE 20MG CAP (HEA/ATB) 30'S A 0.0633 20MG 2022-12-07 2024-03-31 No No Change Local Agent 6
41 B041EL OMEPRAZOLE 20MG CAP (HEA) (C) 30'S C 0.0761 20MG 30 2024-04-01 2026-03-31 6
40 B041EP OMEPRAZOLE 20MG CAP (HEA/RXP) 30'S A 0.06 20MG 30 2022-04-01 2024-03-31 6
40 B041MH OMEPRAZOLE 20MG TAB (MCP/AHI) 2X10 A 0.04 20MG 30 2022-04-01 2024-03-31 6
41 B041MH OMEPRAZOLE 20MG TAB (MCP) 2X10 A 0.0448 20MG 30 2024-04-01 2026-03-31 6
40 B041NJ OMEPRAZOLE 20MG CAP (FSB/ATB) 100'S A 0.07 20MG 30 2022-04-01 2024-03-31 Add to Contract as Cat A 6
41 B041PK OMEVAN 20MG CAP (TPP) OMEPRAZOLE 10X10 A 0.0201 20MG 30 2024-04-01 2026-03-31 6
41 B041PL OMETAB 20MG TAB (INP) OMEPRAZOLE 3X10 A 0.0498 20MG 30 2024-04-01 2026-03-31 6
40 B042BJ OMEPRAZOLE 40MG INJ (CHC/ATB) 40MG VIAL B 1.03 40MG 0 2022-04-01 2024-03-31 0
41 B042BW OMEPRAZOLE 40MG INJ PWDR FOR SOLN (FSB) (B) 40MG VIAL B 1.1417 40MG 0 2024-04-01 2026-03-31 0