Displaying 4721 - 4740 of 5993
Contract Number Brand Code Brand Name Active Ingredient Trade Name Package Size Formulary Category Pkg Price Unit Price Unit Description Max. Reimbursable Quantity / Month Package Description Manufacturer Code Manufacturer Name Agent Code Agent Name Benefit Therapeutic Code Therapeutic Desc Drug Contract Start Date Drug Contract End Date Status Description Default Route Max Repeats Therapeutic Head Amend Date
40 7621Z MICROGYNON-30 30MCG | 150MCG TAB (BSP/COL) ETHI ETHINYL ESTRADIOL|LEVONORGESTREL MICROGYNON-30 21'S B 4.49 4.49 TABLET 0 PACK BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 6812 CONTRACEPTIVES 2022-04-01 2024-03-31 Oral 0 HORMONES AND SYNTHETIC SUBSTITUTES
41 7621Z MICROGYNON-30 30MCG|150MCG TAB (BSP) ETH (B) ETHINYL ESTRADIOL|LEVONORGESTREL MICROGYNON-30 21'S B 4.49 4.4852 PACK 3 BOX BSP BAYER SCHERING PHARMA AG. COL COLLINS LTD 6812 CONTRACEPTIVES 2024-04-01 2026-03-31 ORAL 6 CONTRACEPTIVES
42 7621Z MICROGYNON-30 30MCG|150MCG TAB (BSP) ETHINYL ESTRADIOL|LEVON ETHINYL ESTRADIOL|LEVONORGESTREL MICROGYNON-30 21'S BC 3.04 3.04 PACK 3 BOX BSP BAYER SCHERING PHARMA AG. COL AVENTA BARBADOS 6812 CONTRACEPTIVES 2026-04-01 2028-03-31 ORAL 0 CONTRACEPTIVES
40 76712 ACTILYSE 50MG INJ (BOE/STO) ALTEPLASE ALTEPLASE ACTILYSE 2X50MG BQ 4,817.93 2,408.97 INJECTION 0 VIAL BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD 201220 THROMBOLYTIC AGENTS 2022-04-01 2024-03-31 IV 0 BLOOD FORMATION, COAGULATION AND THROMBOSIS
41 76712 ACTILYSE 50MG INJ (BOE) ALTEPLASE (BQ) ALTEPLASE ACTILYSE 2X50MG BQ 5307.23 2653.6143 VIAL 0 BOX BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD 201220 THROMBOLYTIC AGENTS 2024-04-01 2026-03-31 IV 0 THROMBOLYTIC AGENTS
42 76712 ACTILYSE 50MG INJ (BOE) ALTEPLASE ALTEPLASE ACTILYSE 2X50MG BQ 5,307.23 2,653.62 VIAL 0 VIAL BOE BOEHRINGER INGELHEIM STO BRYDEN STOKES LTD 201220 THROMBOLYTIC AGENTS 2026-04-01 2028-03-31 IV 0 THROMBOLYTIC AGENTS
40 7691C INTERFERON ALPHA 2B 3MU INJ (RLS/AHI) INTERFERON ALPHA 2B INTERFERON ALPHA 2B 3MU VIAL C 49.72 49.72 INJECTION 0 VIAL RLS RELIANCE LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 081820 INTERFERONS 2022-04-01 2024-03-31 IV 0 ANTI-INFECTIVE AGENTS
41 7691C INTERFERON ALPHA 2B 3MU INJ (RLS) INTERFERON ALPHA 2B INTERFERON ALPHA 2B 3MU VIAL C 23.65 23.6494 VIAL 0 VIAL RLS RELIANCE LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 081820 INTERFERONS 2024-04-01 2026-03-31 IV 0 INTERFERONS
42 7691D RELIFERON 300MU/0.5ML INJ (RLS) INTERFERON ALPHA 2B INTERFERON ALPHA 2B RELIFERON 3MU VIAL BQ 24.14 24.14 VIAL 0 VIAL RLS RELIANCE LIFE SCIENCES AHI ARMSTRONG HEALTHCARE INC 081820 INTERFERONS 2026-04-01 2028-03-31 SC 0 INTERFERONS
41 77013 GOTABIOTIC F 0.1%|0.3% EYE DR (LPO) DEXAMETHASONE|TOBRAMYCIN (C) DEXAMETHASONE|TOBRAMYCIN GOTABIOTIC F 5ML C 7.58 7.5841 BOTT 0 BOTT LPO LABORATORIOS POEN S.A. COL COLLINS LTD 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 ORAL 0 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS
40 7701D DEXAMETHASONE/TOBRAMYCIN EYE DR (CIR/AHI) DEXAMETHASONE|TOBRAMYCIN DEXAMETHASONE|TOBRAMYCIN 5ML BQ 5.16 5.16 EYE DROP 0 BOTT CIR CIRON PHARMA AHI ARMSTRONG HEALTHCARE INC 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2022-04-01 2024-03-31 OPHTHALMIC 6 EYE, EAR, NOSE AND THROAT PREPARATIONS
41 7701D DEXAMETHASONE|TOBRAMYCIN 0.1%|0.3% EYE DR (CIR) (BQ) DEXAMETHASONE|TOBRAMYCIN DEXAMETHASONE|TOBRAMYCIN 5ML BQ 5.16 5.1648 BOTT 0 BOTT CIR CIRON PHARMA AHI ARMSTRONG HEALTHCARE INC 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 OPHTHALMIC 0 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS
40 7701E DEXAMETHASONE/TOBRAMYCIN EYE DR (KWA/ATB) DEXAMETHASONE|TOBRAMYCIN DEXAMETHASONE|TOBRAMYCIN 5ML BQ 5.41 5.41 EYE DROP 0 BOTT KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2022-04-01 2024-03-31 OPHTHALMIC 6 EYE, EAR, NOSE AND THROAT PREPARATIONS
40 7701H TOBRADEX 0.1% | 0.3% EYE DR (NVS/COL) DEXAMETHA DEXAMETHASONE|TOBRAMYCIN TOBRADEX 5ML C 21.09 21.09 EYE DROP 0 BOTT NVS NOVARTIS CARIBE SA COL COLLINS LTD 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2022-04-01 2024-03-31 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS
41 7701H TOBRADEX 0.1%|0.3% EYE DR (NVS) DEXAMETHASONE|TOBRAMYCIN (C) DEXAMETHASONE|TOBRAMYCIN TOBRADEX 5ML C 23.79 23.7853 BOTT 0 BOTT NVS NOVARTIS CARIBE SA COL COLLINS LTD 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 OPHTHALMIC 0 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS
42 7701H TOBRADEX 0.1%|0.3% EYE DR (NVS) DEXAMETHASONE|TOBRAMYCIN DEXAMETHASONE|TOBRAMYCIN TOBRADEX 5ML C 23.79 23.79 BOTT 0 BOTT NVS NOVARTIS CARIBE SA COL AVENTA BARBADOS 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2026-04-01 2028-03-31 OPHTHALMIC 0 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS
41 7701J TOBAGRAM D 0.1%|0.3% EYE DR (HAN) DEXAMETHASONE|TOBRAMYCIN (BQ) DEXAMETHASONE|TOBRAMYCIN TOBAGRAM D 10ML BQ 4.27 4.2678 BOTT 0 BOTT HAN HANUCHEM LABORATORIES PSB PHARMACEUTICAL SOLUTIONS BARBA 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 OPHTHALMIC 0 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS
42 7701J TOBAGRAM D 0.1%|0.3% EYE DR (HAN) DEXAMETHASONE|TOBRAMYCIN DEXAMETHASONE|TOBRAMYCIN TOBAGRAM D 10ML BQ 4.30 4.29 BOTT 0 BOTT HAN HANUCHEM LABORATORIES PSB PHARMACEUTICAL SOLUTIONS BARBA 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2026-04-01 2028-03-31 OPHTHALMIC 0 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS
40 77022 GOTABIOTIC F EYE OINT (LPO/COL) DEXAMETHASON DEXAMETHASONE|TOBRAMYCIN GOTABIOTIC F 3.5G C 11.69 11.69 EYE OINTMENT 0 TUBE LPO LABORATORIOS POEN S.A. COL COLLINS LTD 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2022-04-01 2024-03-31 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS
41 77022 GOTABIOTIC F EYE OINT (LPO) DEXAMETHASO (C) DEXAMETHASONE|TOBRAMYCIN GOTABIOTIC F 3.5G C 12.86 12.8577 TUBE 0 BOX LPO LABORATORIOS POEN S.A. COL COLLINS LTD 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 OPHTHALMIC 0 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS