Displaying 1 - 10 of 10
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 14717 CLONOTRIL 0.5MG TAB (REM/SBI) CLONAZEPAM 100'S A 0.03 0.5MG 240 2022-04-01 2022-06-22 Delete from contract 6
40 1471G CLONOTRIL 0.5MG TAB (REM/SBI) CLONAZEPAM 30'S A 0.03 0.5MG 240 2022-05-11 2024-03-31 Package Size Change 6
41 1471G CLONOTRIL 0.5MG TAB (REM) CLONAZEPA (C) 30'S C 0.1142 0.5MG 240 2024-04-01 2026-03-31 6
40 1471K APO-CLONAZEPAM 0.5MG TAB (APO/COL) 500'S A 0.04 0.5MG 240 2022-04-01 2024-03-31 6
41 1471P APO-CLONAZEPAM 0.5MG TAB (APO) 500'S A 0.035 0.5MG 240 2024-04-01 2026-03-31 6
40 14723 PMS-CLONAZEPAM 2MG TAB (PMS/COL) 100'S A 0.05 2MG 300 2022-04-01 2024-03-31 6
40 14726 APO-CLONAZEPAM 2MG TAB (APO/COL) 100'S A 0.06 2MG 300 2022-04-01 2024-03-31 6
40 1472B CLONOTRIL 2MG TAB (REM/SBI) CLONAZEPAM 3X10 C 0.14 2MG 0 2022-04-01 2024-03-31 0
41 1472B CLONOTRIL 2MG TAB (REM) CLONAZEPAM (C) 3X10 C 0.1414 2MG 300 2024-04-01 2026-03-31 6
41 1472R APO-CLONAZEPAM 2MG TAB (APO) 100'S A 0.0555 2MG 300 2024-04-01 2026-03-31 6