Displaying 2381 - 2400 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 3681T NALOXONE 0.4MG/ML INJ (MON/PHA) 5X1ML BQ 2.71 0.4MG/ML 0 2022-04-01 2024-03-31 0
40 3681T NALOXONE 0.4MG/ML INJ (MON/PHA) 5X1ML BQ 2.708 0.4MG/ML 2023-03-20 2024-03-31 No No Delete from contract
42 3681T NALOXONE 0.4MG/ML INJ (MON) 5X1ML B 3.20 0.4MG/ML 0 2026-04-01 No No 0
40 3681V NALOXONE 0.4MG/ML AMP (RTM/PHA) 10'S 5.786 0.4MG/ML 2023-03-20 2024-03-31 No No Price Change
41 3681W NALOXONE 0.4MG/ML INJ (OMG) (B) 10X1ML B 4.7353 0.4MG/ML 0 2024-04-01 2026-03-31 0
42 3681W NALOXONE 0.4MG/ML INJ (OMG) 10X1ML B 5.22 0.4MG/ML 0 2026-04-01 No No 0
40 37019 FREESTYLE OPTIUM GLUC (ABD/PHA) DIAGNOSTIC B 50'S A 42.11 1 2022-04-01 2024-03-31 6
40 37019 FREESTYLE OPTIUM GLUC (ABD/PHA) DIAGNOSTIC B 50'S A 40.01 2023-02-20 2024-03-31 No No Price Change 6
41 37019 FREESTYLE OPTIUM GLUC (ABD) DIAGNOSTIC 50'S A 42.134 1 2024-04-01 2026-03-31 6
42 37019 FREESTYLE OPTIUM GLUC (ABD) DIAGNOSTIC 50'S A 42.13 1 2026-04-01 No No Price Change 6
40 3701AP BAYER NEXT EZ GLUC (BYC/AHI) DIAGNOSTIC BLOO 50'S A 40.23 1 2022-04-01 2024-03-31 6
41 3701AP CONTOUR NEXT GLUC (BYC) DIAGNOSTIC BLOOD GLUCOSE 50'S A 40.2312 1 2024-04-01 2026-03-31 6
42 3701AP CONTOUR NEXT GLUC (BYC) DIAGNOSTIC BLOOD GLUCOSE 50'S A 41.64 1 2026-04-01 No No 6
40 3701AW TRUE METRIX (HOM/ALI) DIAGNOSTIC BLOOD GLUC 50'S A 30.04 1 2022-04-01 2024-03-31 6
40 3701AX FREESTYLE NEO H GLUC (ABD/SBI) DIAGNOSTIC BL 50'S BQ 40.10 0 2022-04-01 2024-03-31 0
41 3701AX FREESTYLE NEO H GLUC (ABD) DIAGNOSTIC B 50'S BQ 54.5 1 2024-04-01 2026-03-31 6
42 3701AX FREESTYLE NEO H GLUC (ABD) DIAGNOSTIC B 50'S B 40.10 1 2026-04-01 No No 6
40 3701AZ FREESTYLE OPTIUM GLUC (ABD/SBI) DIAGNOSTIC B 50'S A 40.10 1 2022-04-01 2024-03-31 6
41 3701AZ FREESTYLE OPTIUM GLUC (ABD) DIAGNOSTIC 50'S A 42.13 1 2024-04-01 2026-03-31 6
42 3701AZ FREESTYLE OPTIUM GLUC (ABD) DIAGNOSTIC 50'S A 40.10 1 2026-04-01 2028-03-31 No No 6