Displaying 1 - 12 of 12
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 0012BA APO-CETIRIZINE 10MG TAB (APO/COL) 100'S A 0.08 10MG 14 2022-04-01 2024-03-31 0
41 0012ES RHINIL SR 10MG TAB (ARP/AHI) CETIRIZINE 100'S A 0.0742 10MG 14 0
41 0012FF APO-CETIRIZINE 10MG TAB (APO/ATB) 100'S A 0.0854 10MG 14 0
41 0012FN CETVAN 10MG TAB (TPP/AHI) CETIRIZINE 10X10 A 0.0544 10MG 14 0
40 0012V CETIRIZINE 10MG TAB (HEA/RXP) 1X10 A 0.10 10MG 14 2022-04-01 2024-03-31 0
41 0012Y ZYRTEC 10MG TAB (GSK/COL) CETIRIZINE 20'S C 1.1376 10MG 14 0
40 0012Y ZYRTEC 10MG TAB (GSK/COL) CETIRIZINE 20'S C 1.03 10MG 0 2022-04-01 2024-03-31 0
40 0013AF ZYRTEC 10MG/ML DROPS (GSK/COL) CETIRIZINE 10ML C 11.85 10MG/ML 0 2022-04-01 2024-03-31 0
40 0013K CETIRIZINE 1MG/ML SYR (HEA/RXP) 60ML A 0.04 1MG/ML 60 2022-04-01 2024-03-31 0
41 0013KA CETIRIZINE 1MG/ML SYR (HEA/ATB) 60ML A 0.0485 1MG/ML 60 0
41 0013T ZYRTEC 1MG/ML SYR (GSK/COL) CETIRIZINE 60ML C 0.2052 1MG/ML 60 0
40 0013T ZYRTEC 1MG/ML SYR (GSK/COL) CETIRIZINE 60ML C 0.19 1MG/ML 0 2022-04-01 2024-03-31 0