Displaying 2441 - 2460 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
42 375E1 DIANEAL (5B9876) 2.5% SOLN (BAX) DIALYSIS SOLN 6X2L BQ 34.74 2.5% 0 2026-04-01 2028-03-31 No No Delete from contract 0
42 375E7 DIANEAL (5B9876) 2.5% SOLN (BAX) DIALYSIS SOLN 6X2 LITRE BQ 34.74 2.5% 0 2026-04-01 No No Add to Contract as Cat B 0
40 375F1 DIANEAL (5B9896) 4.25% INJ (BAX/STO) DIALYSIS SOLN 6X2L B 18.49 4.25% 0 2022-04-01 2024-03-31 0
41 375F1 DIANEAL (5B9896) 4.25% INJ (BAX) DIALYSIS SOLN 6X2L B 22.2 4.25% 100 2024-04-01 2026-03-31 0
42 375F1 DIANEAL (5B9896) 4.25% SOLN (BAX) DIALYSIS SOLN 6X2L BQ 34.74 4.25% 0 2026-04-01 No No Delete from contract 0
42 375F6 DIANEAL (5B9896) 4.25% SOLN (BAX) DIALYSIS SOLN 6X2 LITRE BQ 34.74 4.25% 0 2026-04-01 No No Add to Contract as Cat B 0
40 37617 TYPHIM V1 (AVP/COL) TYPHOID 1 DS SYRNG B 31.80 25MCG 0 2022-04-01 2024-03-31 0
41 37617 TYPHIM V1 (AVP) TYPHOID 1 DS VIAL B 33.4082 25MCG 1 2024-04-01 2024-10-21 0
40 37834 DEXTROSE | SODIUM CHLORIDE 5% | 0.2% INJ (BAX/STO) 1 LITRE B 4.62 5%|0.2% 0 2022-04-01 2024-03-31 0
41 37834 DEXTROSE|SODIUM CHLORIDE 5%|0.2% INJ (BAX) (B) 1 LITRE B 7.8288 5%|0.2% 0 2024-04-01 2026-03-31 0
42 37834 DEXTROSE|SODIUM CHLORIDE 5%|0.2% INJ (BAX) 1 LITRE B 8.51 5%|0.2% 0 2026-04-01 No No 0
40 37842 DEXTROSE | SODIUM CHLORIDE 5% | 0.9% INJ (BAX/STO) 250ML B 3.07 5%|0.9% 0 2022-04-01 2024-03-31 0
41 37845 DEXTROSE|SODIUM CHLORIDE 5%|0.9% INJ (CSC) (B) 250ML B 2.1475 5%|0.9% 100 2024-04-01 2026-03-31 0
40 3785D DEXTROSE | SODIUM CHLORIDE 5% | 0.9% INJ (BAX/STO) 500ML B 3.34 5%|0.9% 0 2022-04-01 2024-03-31 0
41 3785D DEXTROSE|SODIUM CHLORIDE 5%|0.9% INJ (BAX) (B) 500ML B 5.0289 5%|0.9% 100 2024-04-01 2026-03-31 0
42 3785D DEXTROSE|SODIUM CHLORIDE 5%|0.9% INJ (BAX) 500ML B 6.22 5%|0.9% 100 2026-04-01 No No 0
40 3785G DEXTROSE | SODIUM CHLORIDE 5% | 0.9% INJ (CSC/PHA) 500ML B 2.85 5%|0.9% 0 2022-04-01 2022-06-15 Price Change 0
40 3785G DEXTROSE | SODIUM CHLORIDE 5% | 0.9% INJ (CSC/PHA) 500ML B 3.79 5%|0.9% 0 2022-06-16 2024-03-31 Price Change 0
41 3785G DEXTROSE|SODIUM CHLORIDE 5%|0.9% INJ (CSC) (B) 500ML B 2.4465 5%|0.9% 100 2024-04-01 2026-03-31 0
40 37862 DEXTROSE | SODIUM CHLORIDE 5% | 0.9% INJ (BAX/STO) 1 LITRE B 3.18 5%|0.9% 0 2022-04-01 2024-03-31 0