Displaying 3121 - 3140 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 4701BS POLYETHYLENE GLYCOL|PROPYLENE GLYCOL 0.4%|0.3% EYE DR (CHC) 15ML A 1.25 0.4%|0.3% 1 2026-04-01 No No Add to Contract as Cat A 6
40 4701F DROPSTAR 0.4% EYE DR (LPO/COL) SOD. HYALURONA 10ML A 7.61 0.4% 1 2022-04-01 2024-03-31 6
41 4701F DROPSTAR 0.4% EYE DR (LPO) SOD. HYALURON (C) 10ML C 8.3724 0.4% 1 2024-04-01 2026-03-31 6
40 4701K OPTIVE .05%C/0.9%G EYE DR (ALL/COL) CARBOXY/G 15ML C 13.59 0.05%|0.9% 0 2022-04-01 2024-03-31 0
41 4701K OPTIVE 0.5%|0.9% EYE DR (ALL) CARBOXYMETHYLCELLULOSE|GLYCERI (C) 15ML C 13.5916 0.5%|0.9% 0 2024-04-01 2026-03-31 0
40 4701T ACRYLARM 0.2% GEL (LPO/COL) POLYACRYLIC ACID 10G B 11.15 0.2% 1 2022-04-01 2024-03-31 6
41 4701T ACRYLARM 0.2% GEL (LPO) POLYACRYLIC ACID (B) 10G B 12.2596 0.2% 1 2024-04-01 2026-03-31 6
42 4701T ACRYLARM 0.2% GEL (LPO) POLYACRYLIC ACID 10G B 20.39 0.2% 1 2026-04-01 No No 6
40 47127 ERGOMETRINE MALEATE 500MCG/ML INJ (SGH/COL) 1ML AMP BQ 67.96 500MCG/ML 0 2022-04-01 2024-03-31 0
40 4811D HYDROXYCOBALAMINE 1MG/ML INJ (RTM/PHA) 10X1ML B 1.49 1MG/ML 0 2022-04-01 2024-03-31 0
42 4811D HYDROXYCOBALAMINE 1MG/ML INJ (RTM) 10X1ML B 1.39 1MG/ML 3 2026-04-01 No No 0
41 4811M HYDROXYCOBALAMINE 1MG/ML INJ (KWA) 10X1ML B 6.7931 1MG/ML 3 2024-04-01 2026-03-31 0
42 4811Q HYDROXYCOBALAMINE 1MG/ML INJ (FSB) 10X1ML B 1.67 1MG/ML 3 2026-04-01 No No Add to Contract as Cat B 0
40 48411 IMOVANE 7.5MG TAB (SFA/COL) ZOPICLONE 20'S C 0.23 7.5MG 0 2022-04-01 2024-03-31 0
40 48412 APO-ZOPICLONE 7.5MG TAB (APO/COL) 500'S A 0.19 7.5MG 30 2022-04-01 2024-03-31 6
42 48412 APO-ZOPICLONE 7.5MG TAB (APO) 500'S A 0.19 7.5MG 30 2026-04-01 No No 6
41 48413 APO-ZOPICLONE 7.5MG TAB (APO) 500'S A 0.193 7.5MG 30 2024-04-01 2026-03-31 6
41 48416 PMS-ZOPICLONE 7.5MG TAB (PMS) 100'S A 0.1318 7.5MG 30 2024-04-01 2026-03-31 6
42 48416 PMS-ZOPICLONE 7.5MG TAB (PMS) 100'S A 0.12 7.5MG 30 2026-04-01 No No 6
40 4841F ZOPICON 7.5MG TAB (INP/AAL) ZOPICLONE 100'S A 0.19 7.5MG 30 2022-04-01 2024-03-31 6