Displaying 1 - 10 of 10
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 A6911 TRILEPTAL 300MG TAB (NVS/COL) OXCARBAZEPINE 20'S C 1.36 300MG 0 2022-04-01 2024-03-31 0
41 A6911 TRILEPTAL 300MG TAB (NVS) OXCARBAZEPINE (C) 20'S C 1.3592 300MG 120 2024-04-01 2026-03-31 6
40 A691J APO-OXCARBAZEPINE 300MG TAB (APO/COL) 100'S A 0.59 300MG 120 2022-04-01 2024-03-31 6
41 A691L OXCARBAZEPINE 300MG TAB (CAM) 50'S A 0.4692 300MG 120 2024-04-01 2026-03-31 6
41 A691N APO-OXCARBAZEPINE 300MG TAB (APO) O 100'S A 0.6062 300MG 120 2024-04-01 2026-03-31 6
40 A692E APO-OXCARBAZEPINE 600MG TAB (APO/COL) 100'S A 0.79 600MG 120 2022-04-01 2024-03-31 6
41 A692F OXCARBAZEPINE 600MG TAB (CAM) 50'S A 0.7535 600MG 120 2024-04-01 2026-03-31 6
41 A692H APO-OXCARBAZEPINE 600MG TAB (APO) O 100'S A 0.8041 600MG 120 2024-04-01 2026-03-31 6
40 A6931 TRILEPTAL 60MG/ML SUSP (NVS/COL) OXCARBAZEPIN 100ML A 0.27 60MG/ML 600 2022-04-01 2024-03-31 6
41 A6931 TRILEPTAL 60MG/ML SUSP (NVS) OXCARBAZEPI 100ML A 0.2735 60MG/ML 600 2024-04-01 2026-03-31 6