Displaying 1 - 20 of 23
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 52716 APO-PREGABALIN 50MG CAP (APO/COL) 100'S B 0.15 50MG 0 2022-04-01 2024-03-31 6
41 5271C PREGABALIN 50MG CAP (MSN) (B) 30'S B 0.1296 50MG 60 2024-04-01 2026-03-31 6
40 52721 LYRICA 75MG TAB (PFI/STO) PREGABALIN 28'S C 2.41 75MG 0 2022-04-01 2024-03-31 0
41 52721 LYRICA 75MG TAB (PFI) PREGABALIN (C) 28'S C 2.43 75MG 120 2024-04-01 2026-03-31 6
40 52725 LYRICA 75MG TAB (PFI/SBI) PREGABALIN 28'S C 2.41 75MG 0 2022-04-01 2024-03-31 0
41 52725 LYRICA 75MG TAB (PFI) PREGABALIN (C) 28'S C 2.43 75MG 120 2024-04-01 2026-03-31 6
40 52728 APO-PREGABALIN 75MG CAP (APO/COL) 100'S B 0.20 75MG 0 2022-04-01 2024-03-31 6
41 5272V PREGASAFE 75MG CAP (MSN) PREGABALIN (B) 3X10 B 0.1133 75MG 120 2024-04-01 2026-03-31 6
40 5272W PREGABALIN 75MG TAB (MCP/AHI) 3X10 B 0.12 75MG 0 2022-04-01 2024-03-31 6
41 52735 PREGABALIN 100MG CAP (GLP) (C) 100'S C 0.6013 100MG 0 2024-04-01 2026-03-31 0
40 52741 LYRICA 150MG TAB (PFI/STO) PREGABALIN 28'S C 3.62 150MG 0 2022-04-01 2024-03-31 0
41 52741 LYRICA 150MG TAB (PFI) PREGABALIN (C) 28'S C 3.6571 150MG 120 2024-04-01 2026-03-31 6
40 52745 LYRICA 150MG TAB (PFI/SBI) PREGABALIN 28'S C 3.62 150MG 0 2022-04-01 2024-03-31 0
41 52745 LYRICA 150MG TAB (PFI) PREGABALIN (C) 28'S C 3.6571 150MG 120 2024-04-01 2026-03-31 6
40 52747 APO-PREGABALIN 150MG CAP (APO/COL) 100'S B 0.26 150MG 0 2022-04-01 2024-03-31 6
41 5274N PREGASAFE 150MG CAP (MSN) PREGABALIN (B) 3X10 B 0.1812 150MG 120 2024-04-01 2026-03-31 6
40 5274P PREGABALIN 150MG TAB (MCP/AHI) 3X10 B 0.19 150MG 0 2022-04-01 2024-03-31 6
40 52761 LYRICA 300MG TAB (PFI/STO) PREGABALIN 28'S C 5.49 300MG 0 2022-04-01 2024-03-31 0
41 52761 LYRICA 300MG TAB (PFI) PREGABALIN (C) 28'S C 5.5347 300MG 60 2024-04-01 2026-03-31 6
40 52763 LYRICA 300MG TAB (PFI/SBI) PREGABALIN 28'S C 5.49 300MG 0 2022-04-01 2024-03-31 0