Displaying 2161 - 2180 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 31715 HUMIRA AC PEN 40MG INJ (ABB/PHA) ADALIMUMAB 2X40MG C 2,144.38 40MG 0 2022-04-01 2024-03-31 0
41 31715 HUMIRA AC PEN 40MG INJ (ABB) ADALIMUMAB (C) 2X40MG C 1070.9517 40MG 0 2024-04-01 2026-03-31 0
42 31715 HUMIRA AC PEN 40MG INJ (ABB) ADALIMUMAB 2X40MG BQ 883.46 40MG 0 2026-04-01 No No 0
41 31716 HYRIMOZ 40MG INJ (BCH) ADALIMUMAB (C) 2X40MG C 601.0214 40MG 0 2024-04-01 2026-03-31 0
42 31716 HYRIMOZ 40MG INJ (BCH) ADALIMUMAB 2X40MG BQ 601.02 40MG 0 2026-04-01 No No 0
40 31717 ADALIREL 40MG INJ (RLS/AHI) ADALIMUMAB 0.8ML SYRN C 875.30 40MG 0 2022-04-01 2024-03-31 0
41 3171B ERELZI 50MG INJ SOLN (BCH) ETANERCEPT (C) 4X50MG C 399.2063 50MG/ML 1 2024-04-01 2026-03-31 6
42 3171B ERELZI 50MG/ML SOLN FOR INJ (BCH) (C) 4X50MG C 399.21 50MG/ML 0 2026-04-01 No No 0
40 31819 BENZYLBENZOATE 25% EMULSION (GPC/ATB) 120ML A 0.03 25% 100 2022-04-01 2024-03-31 6
41 31819 BENZYLBENZOATE 25% EMULSION (GPC) 120ML A 0.0748 25% 100 2024-04-01 2026-03-31 6
40 3181D BENZYLBENZOATE 25% EMUL (PDN/PHA) 1 LITRE A 0.02 25% 100 2022-04-01 2024-03-31 6
40 3203F HEXITANE 5% SOLN (GNT/AHI) CHLORHEXIDINE 4 LITRES B 12.35 5% 0 2022-04-01 2024-03-31 0
42 3261AB POVIDONE IODINE 1% SOLN (FSB) 1 LITRE B 0.02 1% 500 2026-04-01 No No Add to Contract as Cat B 6
40 3261B VIDENE ANTISEPTIC 1% SOLN (ECO/COL) POVIDONE 500ML B 0.03 1% 0 2022-04-01 2024-03-31 0
40 3261S POVIDONE IODINE 1% SOLN (RIM/PHA) 16OZ B 0.0422 1% 2023-03-20 2024-03-31 No No Add to Contract as Cat B
40 3261U POVIDONE IODINE 1% SOLN (RYV/ATB) 500ML B 0.02 1% 0 2022-04-01 2022-07-12 0
40 3261U POVIDONE IODINE 1% SOLN (RYV/ATB) 500ML B 0.02 1% 0 2022-07-13 2024-03-31 Price Change 0
41 3261U POVIDONE IODINE 1% SOLN (RYV) (B) 500ML B 0.027 1% 500 2024-04-01 2024-06-18 6
41 3261U POVIDONE IODINE 1% SOLN (RYV) (B) 500ML B 0.022 1% 500 2024-06-19 2026-03-31 6
41 3261W POVIDONE IODINE 1% SOLN (CAR) POVIDONE IODINE (C) 500ML C 0.0432 1% 500 2024-04-01 2026-03-31 6