Displaying 301 - 320 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 | 0225K | CLOXACILLIN 500MG INJ (MON/PHA) | 500MG VIAL | B | 1.58 | 500MG | 0 | 2022-04-01 | 2024-03-31 | 6 | ||||
| 41 | 0225L | CLOXACILLIN 500MG INJ (JOL) (B) | 500MG VIAL | B | 6.3065 | 500MG | 56 | 2024-04-01 | 2026-03-31 | 6 | ||||
| 41 | 0225M | LACLOXA 500MG INJ (LDP) CLOXACILLIN (B) | 10X5ML | B | 6.2793 | 500MG | 56 | 2024-04-01 | 2026-03-31 | 6 | ||||
| 42 | 0225N | CLOXAMAX 500MG INJ (JLP) CLOXACILLIN | 500MG VIAL | BQ | 5.98 | 500MG | 56 | 2026-04-01 | No | No | 0 | |||
| 40 | 02316 | DULERA 5MCG | 100MCG INHR (MSD/STO) FORMOTEROL | MOMETASONE | 120 DOSES | B | 56.68 | 5MCG|100MCG | 1 | 2022-04-01 | 2024-03-31 | 6 | ||||
| 41 | 02316 | DULERA 5MCG|100MCG INHR (MSD) FORMOTEROL|MOMETASONE (C) | 120 DOSES | C | 58.3896 | 5MCG|100MCG | 1 | 2024-04-01 | 2026-03-31 | 6 | ||||
| 40 | 0231B | SYMBICORT RAPIHALER 80MCG | 4.5MCG INHR (AZN/COL) BUDESONIDE | FORMOTEROL (R) | 120 DOSES | A | 35.23 | 80MCG|4.5MCG | 1 | 2022-04-01 | 2024-03-31 | 6 | ||||
| 41 | 0231B | SYMBICORT RAPIHALER 80MCG|4.5MCG INHR (AZN) BUDESONIDE|FORMO | 120 DOSES | A | 35.2295 | 80MCG|4.5MCG | 1 | 2024-04-01 | 2026-03-31 | 6 | ||||
| 42 | 0231B | SYMBICORT RAPIHALER 80MCG|4.5MCG INHR (AZN) BUDESONIDE|FORMO | 120 DOSES | A | 35.23 | 80MCG|4.5MCG | 1 | 2026-04-01 | No | No | 6 | |||
| 40 | 0231C | SYMBICORT TURBU 80MCG | 4.5MCG INHR (AZN/COL) BUDESONIDE | FORMOTEROL | 60 DOSES | A | 24.27 | 80MCG|4.5MCG | 1 | 2022-04-01 | 2024-03-31 | 6 | ||||
| 41 | 0231C | SYMBICORT TURBU 80MCG|4.5MCG INHR (AZN) BUDESONIDE|FORMOTERO | 60 DOSES | A | 24.2746 | 80MCG|4.5MCG | 1 | 2024-04-01 | 2026-03-31 | 6 | ||||
| 40 | 02326 | DULERA 200MCG/5MCG INHR (MSD/STO) MOMETASONE/ | 120 DOSES | B | 59.26 | 5MCG|200MCG | 1 | 2022-04-01 | 2024-03-31 | 6 | ||||
| 41 | 02326 | DULERA 200MCG/5MCG INHR (MSD) MOMETASONE (B) | 120 DOSES | B | 61.0264 | 5MCG|200MCG | 1 | 2024-04-01 | 2026-03-31 | 6 | ||||
| 40 | 0232D | SYMBICORT TURBU 160MCG | 4.5MCG INHR (AZN/COL) BUDESONIDE | FORMOTEROL (60) | 60 DOSES | A | 32.62 | 160MCG|4.5MCG | 1 | 2022-04-01 | 2024-03-31 | 6 | ||||
| 41 | 0232D | SYMBICORT TURBU 160MCG|4.5MCG INHR (AZN) BUDESONIDE|FORMOTER | 60 DOSES | A | 32.6199 | 160MCG|4.5MCG | 1 | 2024-04-01 | 2026-03-31 | 6 | ||||
| 42 | 0232D | SYMBICORT TURBU 160MCG|4.5MCG INHR (AZN) BUDESONIDE|FORMOTER | 60 DOSES | A | 32.62 | 160MCG|4.5MCG | 1 | 2026-04-01 | No | No | 6 | |||
| 40 | 0232E | SYMBICORT RAPIHALER 160MCG | 4.5MCG INHR (AZN/COL) BUDESONIDE | FORMOTEROL (120 More ... | 120 DOSES | A | 37.68 | 160MCG|4.5MCG | 1 | 2022-04-01 | 2024-03-31 | 6 | ||||
| 41 | 0232E | SYMBICORT RAPIHALER 160MCG|4.5MCG INHR (AZN) BUDESONIDE|FORM | 120 DOSES | A | 37.676 | 160MCG|4.5MCG | 1 | 2024-04-01 | 2026-03-31 | 6 | ||||
| 42 | 0232E | SYMBICORT RAPIHALER 160MCG|4.5MCG INHR (AZN) BUDESONIDE|FORM | 120 DOSES | A | 37.68 | 160MCG|4.5MCG | 1 | 2026-04-01 | No | No | 6 | |||
| 40 | 0232F | SYMBICORT TURBU 160MCG | 4.5MCG INHR (AZN/COL) BUDESONIDE | FORMOTEROL (120) | 120 DOSES | A | 44.31 | 160MCG|4.5MCG | 1 | 2022-04-01 | 2024-03-31 | 6 | ||||