Displaying 181 - 200 of 5993
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 0131BE SKAZI 40MG/ML SUSP (SKH/RXP) AZITHROMYCIN 15ML A 0.33 40MG/ML 30 2022-04-01 2024-03-31 0
40 0131CW AZITHROMYCIN 40MG/ML SUSP (KWA/ATB) 15ML A 0.32 40MG/ML 30 2022-04-01 2022-09-30 0
40 0131CX BINOZYT 40MG/ML SUSP (BCH/COL) AZITHROMYCIN 30ML C 0.67 40MG/ML 0 2022-04-01 2024-03-31 0
41 0131CX BINOZYT 40MG/ML SUSP (BCH) AZITHROM (C) 30ML C 0.9704 40MG/ML 30 2024-04-01 2026-03-31 0
42 0131CX BINOZYT 40MG/ML SUSP (BCH) AZITHROM 30ML C 0.97 40MG/ML 30 2026-04-01 No No 0
40 0131DH KLARICID 50MG/ML SUSP (ABB/PHA) CLARITHROMYCI 60ML C 0.26 50MG/ML 0 2022-04-01 2024-03-31 0
40 0131DH KLARICID 50MG/ML SUSP (ABB/PHA) CLARITHROMYCI (C) 60ML C 0.2632 50MG/ML 2022-04-01 2023-03-31 No No Delete from contract 0
40 0131DJ KLARICID 25MG/ML SUSP (ABB/PHA) CLARITHROMYCI 60ML C 0.19 25MG/ML 0 2022-04-01 2024-03-31 0
40 0131DJ KLARICID 25MG/ML SUSP (ABB/PHA) CLARITHROMYCI (C) 60ML C 0.1917 25MG/ML 2022-04-01 2023-03-31 No No Delete from contract 0
41 0131DN AZICURE 40MG/ML SUSP (MBL) AZITHROM 30ML A 0.3081 40MG/ML 30 2024-04-01 2026-03-31 0
40 0131DT SKAZI 40MG/ML SUSP (SKH) 15ML A 40MG/ML 30 0
41 0131DT SKAZI 40MG/ML SUSP (SKH) AZITHROMYCIN 15ML A 0.3298 40MG/ML 30 2024-06-05 2026-03-31 0
41 0131DU KLARICID 50MG/ML SUSP (ABB) CLARITHROMYCIN (C) 60ML C 0.3167 50MG/ML 60 2024-04-01 2026-03-31 0
42 0131DU KLARICID 50MG/ML SUSP (ABB) CLARITHROMYCIN 60ML C 0.27 50MG/ML 60 2026-04-01 No No 0
41 0131DV KLARICID 25MG/ML SUSP (ABB) CLARITHROMYCIN (C) 60ML C 0.2369 25MG/ML 100 2024-04-01 2026-03-31 0
42 0131DV KLARICID 25MG/ML SUSP (ABB) CLARITHROMYCIN 60ML C 0.18 25MG/ML 100 2026-04-01 No No 0
40 0131U ZITHROMAX 40MG/ML SUSP (PFI/STO) AZITHROMYCIN 15ML C 1.98 40MG/ML 0 2022-04-01 2024-03-31 0
41 0131U ZITHROMAX 40MG/ML SUSP (PFI) AZITHRO (C) 15ML C 1.9971 40MG/ML 30 2024-04-01 2026-03-31 0
42 0131U ZITHROMAX 40MG/ML SUSP (PFI) AZITHR 15ML C 2.00 40MG/ML 30 2026-04-01 No No 0
40 0141AH ZITHROMAX 500MG TAB (PFI/STO) AZITHROMYCIN 3'S C 17.67 500MG 0 2022-04-01 2024-03-31 0