Displaying 1 - 4 of 4
  • Print
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
41 6451AE 4-QUIN D 0.1%|0.5% EYE DR (HAN) DEXAMETHASONE|MOXIFLOXACIN (BQ) DEXAMETHASONE|MOXIFLOXACIN 4-QUIN D 5ML BQ 3.94 3.9416 BOTT 1 BOTT HAN HANUCHEM LABORATORIES PSB PHARMACEUTICAL SOLUTIONS BARBA 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 OPHTHALMIC 6 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS
40 6451Z VIGADEXA 0.1% | 0.5% EYE DR (NVS/COL) DEXAMETHA DEXAMETHASONE|MOXIFLOXACIN VIGADEXA 5ML BQ 20.39 20.39 EYE DROP 1 BOTT NVS NOVARTIS CARIBE SA COL COLLINS LTD 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2022-04-01 2024-03-31 OPHTHALMIC 6 EYE, EAR, NOSE AND THROAT PREPARATIONS
41 6451Z VIGADEXA 0.1%|0.5% EYE DR (NVS) DEXAMETHASONE|MOXIFLOXACIN (C) DEXAMETHASONE|MOXIFLOXACIN VIGADEXA 5ML C 20.39 20.3874 BOTT 1 BOTT NVS NOVARTIS CARIBE SA COL COLLINS LTD 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2024-04-01 2026-03-31 OPHTHALMIC 6 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS
42 6451Z VIGADEXA 0.1%|0.5% EYE DR (NVS) DEXAMETHASONE|MOXIFLOXACIN DEXAMETHASONE|MOXIFLOXACIN VIGADEXA 5ML C 20.39 20.39 BOTT 1 BOTT NVS NOVARTIS CARIBE SA COL AVENTA BARBADOS 5206 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS 2026-04-01 OPHTHALMIC 6 ANTIBACTERIAL-ANTI-INFLAMMATORY AGENTS