Displaying 2141 - 2160 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 30828 PRIVIGEN 10% INJ (CSL/AHI) IMMUNOGLOBULIN 100ML BQ 1,413.53 10% 0 2022-04-01 2022-05-10 0
41 30828 PRIVIGEN 10% INJ (CSL) IMMUNOGLOBULIN (BQ) 100ML BQ 1766.9106 10% 50 2024-04-01 2026-03-31 0
41 3082A IMMUNOREL 10% INJ (RLS) IMMUNOGLOBU (BQ) 100ML BQ 1353.7254 10% 50 2024-04-01 2026-03-31 0
42 3082B IMMUNOGLOBULIN 10% INJ (INP) 50ML VIAL BQ 538.83 10% 0 2026-04-01 No No 0
42 3082C NORMOGLOBIN 10% INJ (INC) IMMUNOGLOBULIN HUMAN 50ML VIAL BQ 615.86 10% 0 2026-04-01 No No 0
42 3082D PRIVIGEN 10% INJ (CSL) HUMAN IMMUNOGLOBULIN 100ML BQ 1,603.81 10% 0 2026-04-01 No No Add to Contract 0
40 30914 TETAGAM 250IU INJ (CSL/AHI) TETANUS ANTITOXIN 1ML AMP B 67.96 250IU 0 2022-04-01 2024-03-31 0
41 30914 TETAGAM 250IU INJ (CSL) TETANUS ANTITOXI 1ML AMP B 108.733 250IU 40 2024-04-01 2026-03-31 0
42 3091J TETAGAM P 250IU/ML PREFIL SYRN (CSL) IMMUNOGLOBULIN HUMAN 4X1ML PFS B 108.73 250IU/ML 0 2026-04-01 No No Add to Contract 0
40 3101B TETANUS TOXOID (SII/COL) 10 DS VIAL B 25.01 40IU 0 2022-04-01 2024-03-31 0
41 3101B TETANUS TOXOID (SII) 10 DS VIAL B 25.0086 40IU 40 2024-04-01 2026-03-31 0
40 3151A APO-EZETIMIBE 10MG TAB (APO/COL) 100'S A 0.22 10MG 30 2022-04-01 2024-03-31 6
40 3151C EZETROL 10MG TAB (MSD/STO) EZETIMIBE 30'S C 1.58 10MG 0 2022-04-01 2024-03-31 0
41 3151C EZETROL 10MG TAB (MSD) EZETIMIBE (C) 30'S C 1.592 10MG 30 2024-04-01 2026-03-31 6
42 3151C EZETROL 10MG TAB (MSD) EZETIMIBE 30'S C 1.59 10MG 30 2026-04-01 No No 6
41 3151H APO-EZETIMIBE 10MG TAB (APO) EZETIM 100'S A 0.2218 10MG 30 2024-04-01 2026-03-31 6
42 3151K EZENTIB 10MG TAB (JLP) EZETIMIBE 10X10 A 0.33 10MG 30 2026-04-01 No No 6
40 31712 ENBREL 50MG INJ (PFI/STO) ETANERCEPT 4X50MG C 741.70 50MG 0 2022-04-01 2024-03-31 0
41 31712 ENBREL 50MG INJ (PFI) ETANERCEPT (C) 4X50MG C 748.9662 50MG 1 2024-04-01 2026-03-31 6
42 31712 ENBREL 50MG/ML INJ (PFI) ETANERCEP (C) 4X50MG C 748.97 50MG/ML 0 2026-04-01 No No 0