Displaying 3201 - 3220 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 50512 HYDROGEN PEROXIDE 6% (FED/ATB) 150ML B 0.02 6% 0 2022-05-11 2024-03-31 Change Local Agent 0
40 50514 HYDROGEN PEROXIDE 6% (FED/RXP) 150ML B 0.02 6% 0 2022-04-01 2022-05-11 Delete from contract 0
40 5051H HYDROGEN PEROXIDE 6% (THR/SBI) 200ML B 0.01 6% 0 2022-04-01 2024-03-31 0
41 5051M HYDROGEN PEROXIDE 6% SOLN (LDP) (B) 250ML B 0.0195 6% 0 2024-04-01 2026-03-31 0
42 5051M HYDROGEN PEROXIDE 6% SOLN (LDP) 250ML B 0.02 6% 0 2026-04-01 No No 0
40 5062AB REHYDRATION SALTS (CIP/AHI) 30'S A 0.60 10 2022-04-01 2024-03-31 0
40 5062AD REHYDRATION SALTS PWDR (HEA/RXP) 30'S A 0.62 10 2022-04-01 2024-03-31 0
41 5062AF PROLYTE ORS PWDR (CIP) REHYDRATION SALTS 40'S A 0.598 10 2024-04-01 2026-03-31 0
42 5062AF PROLYTE ORS PWDR (CIP) REHYDRATION SALTS 40'S A 0.60 10 2026-04-01 No No 0
40 5062AJ REHYDRATION SALTS (HEA/ATB) 30'S A 0.6207 13.5G|1.5G|2.6G|2.9G 2022-12-07 2024-03-31 No No Change Local Agent 0
41 5062AK DEX-LITOS PWDR (LAF) REHYDRATION SALTS (C) 25'S C 1.2504 0 2024-04-01 2026-03-31 0
42 5062AK DEX-LITOS PWDR (LAF) REHYDRATION SALTS 25'S C 1.25 10 2026-04-01 No No 0
41 5062AL DEX-LITOS PWDR (LAF) REHYDRATION SALTS (C) 50'S C 1.2776 0 2024-04-01 2026-03-31 0
41 5062AM DEX-LITOS PWDR (LAF) REHYDRATION SALTS (C) 25 SACH C 1.2504 0 2024-04-01 2026-03-31 0
41 5062AN DEX-LITOS PWDR (LAF) REHYDRATION SALTS (C) 50 SACH C 1.2776 0 2024-04-01 2026-03-31 0
42 5062AN DEX-LITOS PWDR (LAF) REHYDRATION SALTS 50 SACH C 1.28 10 2026-04-01 No No 0
41 5062AP REHYDRATION SALTS ORANGE PWDR (MPI) 100'S A 0.3257 10 2024-04-01 2026-03-31 0
40 50831 NEBIDO 250MG/ML INJ (BSP/COL) TESTOSTERONE 4ML VIAL BQ 108.73 250MG/ML 0 2022-04-01 2024-03-31 0
40 50833 NEBIDO 250MG/ML INJ (BSP/AHI) TESTOSTERONE 4ML VIAL BQ 108.73 250MG/ML 0 2022-04-01 2024-03-31 0
42 50837 PRIMOTESTON 250MG/ML INJ (BSP) TESTOSTER 250MG AMP BQ 33.14 250MG/ML 4 2026-04-01 No No 0