Displaying 1 - 7 of 7
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 17015 TRIFLUOPERAZINE 1MG TAB (GPC) 1000'S A 0.0177 1MG 252 2024-04-01 2026-03-31 6
42 17016 TRIFLUOPERAZINE 1MG TAB (MAT) 1000'S A 0.15 1MG 252 2026-04-01 No No 6
40 17025 TRIFLUOPERAZINE 5MG TAB (REM/SBI) 1000'S A 0.06 5MG 180 2022-04-01 2024-03-31 6
41 17025 TRIFLUOPERAZINE 5MG TAB (REM) 1000'S A 0.0553 5MG 252 2024-04-01 2026-03-31 6
42 17025 TRIFLUOPERAZINE 5MG TAB (REM) 1000'S A 0.05 5MG 252 2026-04-01 No No 6
40 17026 AAP-TRIFLUOPERAZINE 5MG TAB (APO/COL) 100'S A 0.06 5MG 180 2022-04-01 2024-03-31 NAME CHANGED TO AAP 6
40 17026 AAP-TRIFLUOPERAZINE 5MG TAB (APO/COL) 100'S A 0.0625 5MG 2022-04-01 2024-03-31 No No Name Change 6