Displaying 2281 - 2300 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 | 3544D | IN FUVITE PAED INJ (BAX) MULTIVITAMINS | 5 PAIRS | B | 40.8782 | 0 | 2024-04-01 | 2026-03-31 | 0 | |||||
| 42 | 3544D | IN FUVITE PAED INJ (BAX) MULTIVITAMINS | 5 PAIRS | B | 66.45 | 20MCG/2ML|1MCG/2ML|140MCG/2ML|17MG/4ML|1MG/4ML|1.4MG/4ML|1.2MG/4ML|0.7MG/4ML|80M More ... | 0 | 2026-04-01 | No | No | 0 | |||
| 40 | 35453 | INFUVITE ADULT INJ (BAX/STO) MULTIVITAMINS | 5 PAIRS | B | 40.23 | 0 | 2022-04-01 | 2024-03-31 | Price Change | 0 | ||||
| 41 | 35453 | INFUVITE ADULT INJ (BAX) MULTIVITAMINS (B) | 5 PAIRS | B | 40.2312 | 0 | 2024-04-01 | 2026-03-31 | 0 | |||||
| 42 | 35453 | INFUVITE ADULT INJ (BAX) MULTIVITAMINS | 5 PAIRS | B | 46.18 | 0 | 2026-04-01 | No | No | 0 | ||||
| 40 | 35462 | PEDIA POLY-VITE DROPS (BYP/PHA) MULTIVITAMINS PAEDIATRIC | 50ML | A | 10.79 | 1 | 2022-04-01 | 2024-03-31 | 6 | |||||
| 41 | 35462 | PEDIA POLY-VITE DROPS (BYP) MULTIVITAMINS PAEDIATRIC | 50ML | A | 11.6616 | 1 | 2024-04-01 | 2026-03-31 | 6 | |||||
| 40 | 35463 | PEDIA POLY-VITE W | IRON DROPS (BYP/PHA) MULTIVITAMINS PAEDIATRIC WITH IRON | 50ML | A | 10.79 | 1 | 2022-04-01 | 2024-03-31 | 6 | |||||
| 41 | 35463 | PEDIA POLY-VITE W|IRON DROPS (BYP) MULTIVITAMINS PAEDIATRIC | 50ML | A | 11.66 | 1 | 2024-04-01 | 2026-03-31 | 6 | |||||
| 40 | 35715 | ALOPRON 100MG TAB (REM/SBI) ALLOPURINOL | 1000'S | A | 0.05 | 100MG | 180 | 2022-04-01 | 2024-03-31 | 6 | ||||
| 41 | 35715 | ALOPRON 100MG TAB (REM) ALLOPURINOL | 1000'S | A | 0.0544 | 100MG | 180 | 2024-04-01 | 2026-03-31 | 6 | ||||
| 42 | 35715 | ALOPRON 100MG TAB (REM) ALLOPURINOL | 1000'S | A | 0.05 | 100MG | 180 | 2026-04-01 | No | No | 6 | |||
| 41 | 3571AW | APO-ALLOPURINOL 100MG TAB (APO) | 1000'S | A | 0.0481 | 100MG | 180 | 2024-04-01 | 2026-03-31 | 6 | ||||
| 40 | 3571ZD | APO-ALLOPURINOL 100MG TAB (APO/COL) | 1000'S | A | 0.05 | 100MG | 180 | 2022-04-01 | 2024-03-31 | 6 | ||||
| 42 | 3571ZD | APO-ALLOPURINOL 100MG TAB (APO) | 1000'S | A | 0.05 | 100MG | 180 | 2026-04-01 | No | No | 6 | |||
| 40 | 3571ZV | ZYLOPRIM 100MG TAB (ASG/STO) ALLOPURINOL | 50'S | C | 0.54 | 100MG | 0 | 2022-04-01 | 2024-03-31 | 0 | ||||
| 41 | 3571ZV | ZYLOPRIM 100MG TAB (ASG) ALLOPURINOL (C) | 50'S | C | 0.5486 | 100MG | 180 | 2024-04-01 | 2026-03-31 | 6 | ||||
| 40 | 3582B | SODIUM BICARBONATE 8.4% INJ (BRA/COL) | 100ML | B | 6.50 | 8.4% | 0 | 2022-04-01 | 2024-03-31 | 0 | ||||
| 41 | 3582B | SODIUM BICARBONATE 8.4% INJ (BRA) (B) | 100ML | B | 6.9589 | 8.4% | 70 | 2024-04-01 | 2026-03-31 | 0 | ||||
| 42 | 3582B | SODIUM BICARBONATE 8.4% INJ (BRA) | 100ML | B | 9.51 | 8.4% | 70 | 2026-04-01 | No | No | 0 | |||