Drugs available on Contract

Displaying 1 - 3 of 3

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	Default Route	Max Repeats	Therapeutic Head
40	A4021	COMBIVENT 0.2MG/ML \| 1MG/ML RESP SOL (BOE/STO) IPRATROPIUM \| SALBUTAMOL	IPRATROPIUM\|SALBUTAMOL	COMBIVENT	20X2.5ML	A	67.14	3.36	RESPIRATORY	20	BOTT	BOE	BOEHRINGER INGELHEIM	STO	BRYDEN STOKES LTD	B	4892	RESPIRATORY AGENTS MISCELLANEOUS	2022-04-01	2024-03-31	INHALATION	6	RESPIRATORY TRACT AGENTS
41	A4021	COMBIVENT 0.2MG/ML\|1MG/ML RESP SOL (BOE) IPRATROPIUM\|SALBUTA	IPRATROPIUM\|SALBUTAMOL	COMBIVENT	20X2.5ML	A	69.15	3.4577	BOX	20	BOTT	BOE	BOEHRINGER INGELHEIM	STO	BRYDEN STOKES LTD	B	4892	RESPIRATORY AGENTS MISCELLANEOUS	2024-04-01	2026-03-31	INHALATION	6	RESPIRATORY AGENTS MISCELLANEOUS
42	A4021	COMBIVENT 0.2MG/ML\|1MG/ML RESP SOL (BOE) IPRATROPIUM\|SALBUTA	IPRATROPIUM\|SALBUTAMOL	COMBIVENT	20X2.5ML	A	69.15	3.46	AMPG	20	AMPG	BOE	BOEHRINGER INGELHEIM	STO	BRYDEN STOKES LTD	B	4892	RESPIRATORY AGENTS MISCELLANEOUS	2026-04-01		INHALATION	6	RESPIRATORY AGENTS MISCELLANEOUS