Displaying 2961 - 2980 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 4361AA BURETROL SOLUTION SET (BAX) ADMIN SET A (B) SET B 3.5338 10 2024-04-01 2026-03-31 0
42 4361AA BURETROL SOLUTION SET (BAX) ADMIN SET A SET B 7.23 10 2026-04-01 No No 0
40 43648 IRRIG SET Y-TYPE (2C4005) (BAX/STO) ADMIN S SET B 15.17 0 2022-04-01 2024-03-31 0
41 43648 IRRIG SET Y-TYPE (2C4005) (BAX) (B) SET B 18.5118 10 2024-04-01 2026-03-31 0
42 43648 IRRIG SET Y-TYPE (2C4005) (BAX) SET B 11.31 10 2026-04-01 No No 0
40 43649 ECOSPIKE (BRA/COL) ADMIN SET GLYCINE SET B 8.45 0 2022-04-01 2024-03-31 0
41 43649 ECOSPIKE (BRA) ADMIN SET GLYCINE (B) SET B 9.3782 10 2024-04-01 2026-03-31 0
42 43649 ECOSPIKE (BRA) ADMIN SET GLYCINE (C) SET C 13.54 10 2026-04-01 No No 0
40 43664 BURETROL INTERLINK ( 2C7564) SET (BAX/STO) SET B 16.74 0 2022-04-01 2024-03-31 0
41 43664 BURETROL INTERLINK ( 2C7564) SET (BAX) (B) SET B 23.7582 10 2024-04-01 2026-03-31 0
42 43664 BURETROL INTERLINK ( 2C7564) SET (BAX) SET B 30.72 10 2026-04-01 2028-03-31 No No 0
40 4366R BURETROL ADD ON CLEARLINK SET (BAX/STO) ADMI SET B 12.37 0 2022-04-01 2024-03-31 0
41 4366R BURETROL ADD ON CLEARLINK SET (BAX) ADM (B) SET B 17.9138 10 2024-04-01 2026-03-31 0
42 4366R BURETROL ADD ON CLEARLINK SET (BAX) ADM SET B 18.65 10 2026-04-01 No No 0
40 4366S BURETROL SOL PAED (2C8862) SET (BAX/STO) ADM SET B 15.85 0 2022-04-01 2024-03-31 0
41 4366S BURETROL SOL PAED (2C8862) SET (BAX) AD (B) SET B 20.9583 10 2024-04-01 2026-03-31 0
40 43683 VENTED PACLITAXEL (2C7557) SET (BAX/STO) ADM SET B 11.55 0 2022-04-01 2024-03-31 0
41 43683 VENTED PACLITAXEL (2C7557) SET (BAX) AD (B) SET B 18.5118 10 2024-04-01 2026-03-31 0
42 43683 VENTED PACLITAXEL (2C7557) SET (BAX) AD SET BQ 24.19 10 2026-04-01 No No 0
40 43684 INTRAFIX PRIME LINE COMFORT PV SET (BRA/COL) ADMIN SET SET B 1.88 0 2022-04-01 2024-03-31 0