Displaying 1 - 11 of 11
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 35911 LAMICTAL 25MG TAB (GSK/COL) LAMOTRIGINE 30'S C 1.38 25MG 0 2022-04-01 2024-03-31 0
41 35911 LAMICTAL 25MG TAB (GSK) LAMOTRIGINE (C) 30'S C 1.5159 25MG 60 2024-04-01 2026-03-31 6
40 3591G PMS-LAMOTRIGINE 25MG TAB (PMS/COL) 100'S B 0.14 25MG 0 2022-04-01 2024-03-31 6
41 3591Q APO-LAMOTRIGINE 25MG TAB (APO) LAMO (B) 100'S B 0.1041 25MG 60 2024-04-01 2026-03-31 6
40 35921 LAMICTAL 50MG TAB (GSK/COL) LAMOTRIGINE 30'S C 2.71 50MG 0 2022-04-01 2024-03-31 0
41 35921 LAMICTAL 50MG TAB (GSK) LAMOTRIGINE (B) 30'S B 2.9784 50MG 60 2024-04-01 2026-03-31 6
40 3592D LAMEZ 50MG TAB (INP/AAL) LAMOTRIGINE 56'S B 1.04 50MG 0 2022-04-01 2024-03-31 6
40 35931 LAMICTAL 100MG TAB (GSK/COL) LAMOTRIGINE 30'S C 2.98 100MG 0 2022-04-01 2024-03-31 0
41 35931 LAMICTAL 100MG TAB (GSK) LAMOTRIGINE (C) 30'S C 3.2801 100MG 60 2024-04-01 2026-03-31 6
40 3593G APO-LAMOTRIGINE 100MG TAB (APO/COL) 100'S B 0.26 100MG 0 2022-04-01 2024-03-31 6
41 3593M APO-LAMOTRIGINE 100MG TAB (APO) LAM (B) 100'S B 0.2645 100MG 60 2024-04-01 2026-03-31 6