Displaying 1 - 8 of 8
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 A5015 DIOVAN 160MG TAB (NVS) VALSARTAN 14'S A 0.6486 160MG 30 2024-09-06 2026-03-31 6
40 A501F DIOVAN 80MG TAB (NVS/COL) VALSARTAN 14'S A 0.65 80MG 30 2022-04-01 2024-03-31 6
41 A501F DIOVAN 80MG TAB (NVS) VALSARTAN 14'S A 0.6485 80MG 30 2024-04-01 2026-03-31 6
40 A501G DIOVAN 160 MG (NVS/COL) 14'S A 0.648 160MG 30 2024-03-31 6
40 A5028 DIOVAN 160MG TAB (NVS/COL) VALSARTAN 28'S A 0.65 160MG 30 2022-04-01 2024-03-31 6
41 A5028 DIOVAN 160MG TAB (NVS) VALSARTAN 28'S A 0.6485 160MG 30 2024-04-01 2026-03-31 6
40 A5029 DIOVAN 320MG TAB (NVS/COL) VALSARTAN 28'S A 0.70 320MG 30 2022-04-01 2024-03-31 6
41 A5029 DIOVAN 320MG TAB (NVS) VALSARTAN 28'S A 0.6961 320MG 30 2024-04-01 2026-03-31 6