Displaying 1 - 18 of 18
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 57514 APO-TERAZOSIN 1MG TAB (APO/COL) 100'S B 0.05 1MG 0 2022-04-01 2024-03-31 0
42 57514 APO-TERAZOSIN 1MG TAB (APO) 100'S B 0.05 1MG 60 2026-04-01 No No 6
41 5751Y APO-TERAZOSIN 1MG TAB (APO) (B) 100'S B 0.0495 1MG 60 2024-04-01 2026-03-31 6
40 57522 HYTRIN 2MG TAB (ABB/PHA) TERAZOSIN 28'S C 0.23 2MG 0 2022-04-01 2024-03-31 0
40 57522 HYTRIN 2MG TAB (ABB/PHA) TERAZOSIN (C) 28'S C 0.2261 2MG 2022-04-01 2023-03-31 No No Delete from contract 0
40 57526 APO-TERAZOSIN 2MG TAB (APO/COL) 100'S B 0.04 2MG 0 2022-04-01 2024-03-31 0
42 57526 APO-TERAZOSIN 2MG TAB (APO) 100'S B 0.04 2MG 60 2026-04-01 No No 6
41 5752AA HYTRIN 2MG TAB (ABB) TERAZOSIN (C) 28'S C 0.2349 2MG 60 2024-04-01 2026-03-31 6
41 5752Z APO-TERAZOSIN 2MG TAB (APO) (B) 100'S B 0.0432 2MG 60 2024-04-01 2026-03-31 6
40 57536 HYTRIN 5MG TAB (ABB/PHA) TERAZOSIN 28'S C 0.23 5MG 0 2022-04-01 2024-03-31 0
40 57536 HYTRIN 5MG TAB (ABB/PHA) TERAZOSIN (C) 28'S C 0.2261 5MG 2022-04-01 2023-03-31 No No Delete from contract 0
40 57538 APO-TERAZOSIN 5MG TAB (APO/COL) 100'S B 0.07 5MG 0 2022-04-01 2024-03-31 0
42 57538 APO-TERAZOSIN 5MG TAB (APO) 100'S B 0.07 5MG 60 2026-04-01 No No 6
41 5753AC APO-TERAZOSIN 10MG TAB (APO) (B) 100'S B 0.1169 10MG 30 2024-04-01 2026-03-31 6
41 5753AD APO-TERAZOSIN 5MG TAB (APO) (B) 100'S B 0.0671 5MG 60 2024-04-01 2026-03-31 6
41 5753AE HYTRIN 5MG TAB (ABB) TERAZOSIN (C) 28'S C 0.2349 5MG 60 2024-04-01 2026-03-31 6
40 5753T APO-TERAZOSIN 10MG TAB (APO/COL) 100'S B 0.11 10MG 0 2022-04-01 2024-03-31 0
42 5753T APO-TERAZOSIN 10MG TAB (APO) 100'S B 0.12 10MG 30 2026-04-01 No No 6