Displaying 2981 - 3000 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 43684 INTRAFIX PRIME LINE COMFORT PV SET (BRA) ADMIN SET (B) SET B 2.1475 10 2024-04-01 2026-03-31 0
40 43719 VIAL PLASTIC, AMBER 15ML/4 DR (DCN/COL) BOT 200'S B 0.14 0 2022-04-01 2024-03-31 0
41 43719 VIAL PLASTIC, AMBER 15ML/4 DR (DCN) 200'S B 0.1502 4 2024-04-01 2026-03-31 0
42 43719 VIAL PLASTIC, AMBER 15ML/4 DR (DCN) 200'S B 0.17 4 2026-04-01 No No 0
40 43728 VIAL, PLASTIC, AMBER 25ML/7 DR (DCN/COL) 200'S B 0.16 0 2022-04-01 2024-03-31 0
41 43729 VIAL, PLASTIC, AMBER 25ML/7 DR (DCN) (B) 500'S B 0.1662 0 2024-04-01 2026-03-31 0
42 43729 VIAL, PLASTIC, AMBER 25ML/7 DR (DCN) VIALS 500'S B 0.19 0 2026-04-01 No No 0
40 43738 VIAL, PLASTIC, AMBER 40ML/10DR (DCN/COL) BO 200'S B 0.22 0 2022-04-01 2024-03-31 0
41 43738 VIAL, PLASTIC, AMBER 40ML/10DR (DCN) 200'S B 0.2311 4 2024-04-01 2026-03-31 0
42 43738 VIAL, PLASTIC, AMBER 40ML/10DR (DCN) 200'S B 0.26 4 2026-04-01 No No 0
40 43749 VIAL, PLASTIC, AMBER 60ML/16DR (DCN/COL) BO 200'S B 0.31 0 2022-04-01 2024-03-31 0
41 43749 VIAL, PLASTIC, AMBER 60ML/16DR (DCN) 200'S B 0.3312 4 2024-04-01 2026-03-31 0
42 43749 VIAL, PLASTIC, AMBER 60ML/16DR (DCN) 200'S B 0.38 4 2026-04-01 No No 0
40 43757 VIAL, PLASTIC AMBER 90ML/30DR (DCN/COL) BOT 100'S B 0.48 0 2022-04-01 2024-03-31 0
41 43757 VIAL, PLASTIC AMBER 90ML/30DR (DCN) 100'S B 0.5086 4 2024-04-01 2026-03-31 0
42 43757 VIAL, PLASTIC AMBER 90ML/30DR (DCN) 100'S B 0.58 4 2026-04-01 No No 0
40 43766 VIAL, PLASTIC AMBER 50ML | 14DR (DCN/COL) BOT 200'S B 0.24 0 2022-04-01 2024-03-31 0
41 43766 VIAL, PLASTIC AMBER 50ML|14DR (DCN) BO (B) 200'S B 0.2573 0 2024-04-01 2026-03-31 0
42 43766 VIAL, PLASTIC AMBER 50ML|14DR (DCN) BO 200'S B 0.59 0 2026-04-01 No No 0
40 43773 VIAL, PLASTIC, AMBER 140ML/40DR (DCN/COL) 100'S B 0.61 0 2022-04-01 2024-03-31 0