Displaying 1 - 20 of 29
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 A7111 RISPERDAL 2MG TAB (JAC/STO) RISPERIDONE 20'S BP 0.97 2MG 60 2022-04-01 2024-03-31 6
41 A7111 RISPERDAL 2MG TAB (JAC) RISPERIDONE (C) 20'S C 0.9704 2MG 60 2024-04-01 2026-03-31 6
42 A7111 RISPERDAL 2MG TAB (JAC) RISPERIDONE 20'S C 0.97 2MG 60 2026-04-01 No No 6
40 A7117 APO-RISPERIDONE 2MG TAB (APO/COL) 100'S A 0.11 2MG 60 2022-04-01 2024-03-31 6
42 A7117 APO-RISPERIDONE 2MG TAB (APO) 100'S A 0.11 2MG 60 2026-04-01 No No 6
40 A711AB RISPERIDONE 2MG TAB (INP/AHI) 50'S A 0.02 2MG 60 2022-04-01 2022-09-30 6
41 A711AB RISDONE 2MG TAB (INP) RISPERIDONE 50'S A 0.0897 2MG 60 2024-04-01 2026-03-31 6
42 A711AB RISDONE 2MG TAB (INP) RISPERIDONE 50'S A 0.09 2MG 60 2026-04-01 No No 6
40 A711AK RISDONE 2MG TAB (INP/AHI) RISPERIDONE 60'S A 0.13 2MG 60 2022-04-01 2024-03-31 6
41 A711AL APO-RISPERIDONE 2MG TAB (APO) 100'S A 0.1109 2MG 60 2024-04-01 2026-03-31 6
40 A7121 RISPERDAL 1MG TAB (JAC/STO) RISPERIDONE 20'S BP 0.97 1MG 60 2022-04-01 2024-03-31 6
41 A7121 RISPERDAL 1MG TAB (JAC) RISPERIDONE (C) 20'S C 0.9704 1MG 84 2024-04-01 2026-03-31 6
42 A7121 RISPERDAL 1MG TAB (JAC) RISPERIDONE 20'S C 0.97 1MG 84 2026-04-01 No No 6
40 A7126 APO-RISPERIDONE 1MG TAB (APO/COL) 100'S A 0.11 1MG 60 2022-04-01 2024-03-31 6
42 A7126 APO-RISPERIDONE 1MG TAB (APO) 100'S A 0.11 1MG 84 2026-04-01 No No 6
40 A712AD RISPERIDONE 1MG TAB (INP/AHI) 50'S A 0.02 1MG 60 2022-04-01 2022-09-30 6
41 A712AD RISDONE 1MG TAB (INP) RISPERIDONE 50'S A 0.1093 1MG 84 2024-04-01 2026-03-31 6
42 A712AD RISDONE 1MG TAB (INP) RISPERIDONE 50'S A 0.06 1MG 84 2026-04-01 No No 6
40 A712AM RISDONE 1MG TAB (INP/AHI) RISPERIDONE 2X10 A 0.20 1MG 60 2022-04-01 2024-03-31 6
41 A712AQ APO-RISPERIDONE 1MG TAB (APO) 100'S A 0.1109 1MG 84 2024-04-01 2026-03-31 6