Displaying 1 - 20 of 31
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 A7718 APO-QUETIAPINE 100MG TAB (APO/COL) 100'S BP 0.28 100MG 30 2022-04-01 2024-03-31 6
40 A771Q QUETIDIN 100MG TAB (ABB/PHA) QUETIAPINE 30'S BP 0.45 100MG 30 2022-04-01 2024-03-31 6
40 A771Q QUETIDIN 100MG TAB (ABB/PHA) QUETIAPINE (BP) 30'S BP 0.4467 100MG 2022-04-01 2023-03-31 No No Delete from contract 6
40 A771S SEROQUEL 100MG TAB (AZN/COL) QUETIAPINE 30'S C 1.28 100MG 30 2022-05-17 2024-03-31 Add to Contract as Cat C 6
41 A771S SEROQUEL 100MG TAB (AZN) QUETIAPINE (C) 30'S C 1.2785 100MG 42 2024-04-01 2026-03-31 6
40 A771V QUETIAPINE 100MG TAB (MCP/AHI) 3X10 BP 0.13 100MG 30 2022-04-01 2024-03-31 6
41 A771V QUETIAPINE 100MG TAB (MCP) (BP) 3X10 BP 0.125 100MG 42 2024-04-01 2026-03-31 6
41 A771Y APO-QUETIAPINE 100MG TAB (APO) (BP) 100'S BP 0.1302 100MG 42 2024-04-01 2026-03-31 6
40 A7726 APO-QUETIAPINE 200MG TAB (APO/COL) 100'S BP 0.34 200MG 0 2022-04-01 2024-03-31 6
40 A772AL QUETIAPINE 200MG TAB (MCP/AHI) 3X10 BP 0.19 200MG 0 2022-04-01 2024-03-31 6
41 A772AL QUETIAPINE 200MG TAB (MCP) (BP) 3X10 BP 0.1885 200MG 120 2024-04-01 2024-12-27 6
41 A772AL QUETIAPINE 200MG TAB (MCP) (BP) 3X10 BP 0.214 200MG 120 2024-12-28 2026-03-31 6
41 A772AN APO-QUETIAPINE 200MG TAB (APO) (BP) 100'S BP 0.1949 200MG 120 2024-04-01 2026-03-31 6
40 A772Z QUETIDIN 200MG TAB (ABB/PHA) QUETIAPINE 30'S BP 0.91 200MG 0 2022-04-01 2024-03-31 6
40 A772Z QUETIDIN 200MG TAB (ABB/PHA) QUETIAPINE (BP) 30'S BP 0.9087 200MG 2022-04-01 2023-03-31 No No Delete from contract 6
40 A7738 APO-QUETIAPINE 25MG TAB (APO/COL) 100'S BP 0.37 25MG 0 2022-04-01 2024-03-31 6
41 A773AB APO-QUETIAPINE 25MG TAB (APO) (BP) 100'S BP 0.0837 25MG 120 2024-04-01 2026-03-31 6
40 A773Q QUETIDIN 25MG TAB (ABB/PHA) QUETIAPINE 30'S BP 0.43 25MG 0 2022-04-01 2024-03-31 6
40 A773Q QUETIDIN 25MG TAB (ABB/PHA) QUETIAPINE (BP) 30'S BP 0.4267 25MG 2022-04-01 2023-03-31 No No Delete from contract 6
40 A773S SEROQUEL 25MG TAB (AZN/COL) QUETIAPINE 30'S BP 0.32 25MG 0 2022-04-01 2024-03-31 6