Displaying 2081 - 2100 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
41 29958 SYNTHROID 75MCG TAB (ABB) THYROXINE 30'S A 0.2582 75MCG 90 2024-04-01 2026-03-31 6
42 29958 SYNTHROID 75MCG TAB (ABB) LEVOTHYROXINE 30'S A 0.23 75MCG 90 2026-04-01 2028-03-31 No No 6
42 2995B EUTIROX NF 75MCG TAB (MEK) LEVOTHYROXINE 50'S A 0.37 75MCG 90 2026-04-01 2028-03-31 No No 6
41 29961 EUTIROX 125MCG TAB (MEK) THYROXINE 50'S A 0.4121 125MCG 30 2024-04-01 2026-03-31 6
42 29963 SYNTHROID 125MCG TAB (ABB) LEVOTHYROXINE 30'S A 0.26 125MCG 30 2026-04-01 No No 6
42 29964 EUTIROX NF 125MCG TAB (MEK) LEVOTHYROXINE 50'S A 0.42 125MCG 30 2026-04-01 No No 6
42 29973 SYNTHROID 150MCG TAB (ABB) LEVOTHYROXINE 30'S A 0.27 150MCG 30 2026-04-01 No No 6
42 29974 EUTIROX NF 150MCG TAB (MEK) LEVOTHYROXINE 50'S A 0.42 150MCG 30 2026-04-01 No No 6
40 30016 BUPIVACAINE 0.25% INJ (KWA/ATB) 10ML BQ 6.12 0.25% 0 2022-04-01 2024-03-31 0
41 30016 BUPIVACAINE 0.25% INJ (KWA) 10ML BQ 5.3551 0.25% 2 2024-04-01 2026-03-31 0
40 3002X LABUPI 0.25% INJ (LDP/AHI) BUPIVACAINE 20ML BQ 15.22 0.25% 0 2022-04-01 2024-03-31 0
40 3002Y BUPIVACAINE 0.25% INJ (KWA/ATB) 20ML BQ 8.56 0.25% 0 2022-04-01 2024-03-31 Add to Contract as Cat B 0
41 3002Y BUPIVACAINE 0.25% INJ (KWA) 20ML BQ 15.9566 0.25% 2 2024-04-01 2026-03-31 0
42 3002Z BUPIVACAINE 0.25% INJ (BAX) 5X20ML BQ 3.54 0.25% 2 2026-04-01 No No 0
42 30034 BUPIVACAINE SPINAL HEAVY 0.5% INJ (RTM) 10X4ML BQ 2.83 0.5% 2 2026-04-01 No No 0
40 3003G BUPIVACINE SPINAL HEAVY 0.5% INJ (BAX/STO) BU 5X4ML BQ 4.02 0.5% 0 2022-04-01 2024-03-31 0
41 3003L BUPIVACAINE HEAVY 0.5% INJ (FSB) (BQ) 5X4ML BQ 1.9681 0.5% 2 2024-04-01 2026-03-31 0
42 3003N BUPIVACAINE HEAVY 0.5% INJ (FSB) 5X4ML BQ 1.84 0.5% 2 2026-04-01 No No Add to Contract 0
40 3004F LABUPI 0.5% INJ (LDP/AHI) BUPIVACAINE 10ML BQ 6.36 0.5% 0 2022-04-01 2024-03-31 0
41 3004H BUPIVACAINE 0.5% INJ (FSB) 20ML BQ 7.5298 0.5% 2 2024-04-01 2026-03-31 0