Displaying 1 - 14 of 14
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
41 A772AJ QUEL 200MG SR TAB (IPC) QUETIAPINE XR (BP) 30'S BP 0.2247 200MG 0 2024-04-01 2026-03-31 0
40 A772AK QUETIDIN XR 200MG TAB (ABB/PHA) QUETIAPINE XR 30'S BP 2.07 200MG 0 2022-04-01 2024-03-31 6
40 A772AK QUETIDIN XR 200MG TAB (ABB/PHA) QUETIAPINE XR (BP) 30'S BP 2.0723 200MG 2022-04-01 2023-03-31 No No Delete from contract 6
40 A774Q SEROQUEL XR 300MG TAB (AZN/COL) QUETIAPINE XR 30'S BP 1.73 300MG 0 2022-04-01 2024-03-31 6
40 A774R QUETIDIN XR 300MG TAB (ABB/PHA) QUETIAPINE XR 30'S BP 2.68 300MG 0 2022-04-01 2024-03-31 6
40 A774R QUETIDIN XR 300MG TAB (ABB/PHA) QUETIAPINE XR (BP) 30'S BP 2.6813 300MG 2022-04-01 2023-03-31 No No Delete from contract 6
40 A774S QUETIAPINE XR 300MG TAB (MCP/AHI) 3X10 BP 0.40 300MG 0 2022-04-01 2024-03-31 6
40 A7757 QUETIDIN XR 50MG TAB (ABB/PHA) QUETIAPINE XR 30'S BP 1.57 50MG 0 2022-04-01 2024-03-31 6
40 A7757 QUETIDIN XR 50MG TAB (ABB/PHA) QUETIAPINE XR (BP) 30'S BP 1.574 50MG 2022-04-01 2023-03-31 No No Delete from contract 6
40 A7758 SEROQUEL XR 50MG TAB (AZN/COL) QUETIAPINE XR 30'S C 1.76 50MG 0 2022-05-17 2024-03-31 Add to Contract as Cat C 0
41 A7758 SEROQUEL 50MG XR TAB (AZN) QUETIAPINE XR 30'S BP 1.7578 50MG 0 2024-04-01 2026-03-31 0
40 A775A QUETIAPINE XR 50MG TAB (MCP/AHI) 3X10 BP 0.19 50MG 0 2022-04-01 2024-03-31 6
40 A7764 SQURO SR 400MG TAB (INP/AAL) QUETIAPINE XR 60'S BP 2.72 400MG 120 2022-04-01 2024-03-31 6
41 A7766 QUETIAPINE 400MG ER TAB (INP) 60'S BP 0.4567 400MG 84 2024-04-01 2026-03-31 6