Displaying 3481 - 3500 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 5281BV APROCIN 0.3% EYE DR (ARP) CIPROFLOXACIN (BH) 10ML BH 8.15 0.3% 0 2024-04-01 2026-03-31 6
41 5281BW FUSITHAL 1% EYE DR (ARP) FUSIDIC ACID 5G A 10.5743 1% 1 2024-04-01 2026-03-31 0
42 5281BW FUSITHAL 1% EYE DR (ARP) FUSIDIC ACID 5G A 10.57 1% 1 2026-04-01 No No 0
40 5281BX OPTIMOX 0.5% EYE DR (ARP/AHI) MOXIFLOXACIN 5ML BQ 8.70 0.5% 0 2022-04-01 2024-03-31 6
41 5281BY T-MYCIN 0.3% EYE DR (ARP) TOBRAMYCI (BH) 5ML BH 5.4366 0.3% 2 2024-04-01 2026-03-31 6
40 5281CB TOBREX 0.3% EYE DR (NVS/COL) TOBRAMYCIN 5ML C 23.30 0.3% 0 2022-04-01 2024-03-31 0
41 5281CB TOBREX 0.3% EYE DR (NVS) TOBRAMYCIN (C) 5ML C 16.3099 0.3% 2 2024-04-01 2026-03-31 6
40 5281CC APO-GATIFLOXACIN 0.3% EYE DR (APO/COL) 5ML BQ 9.51 0.3% 1 2022-04-01 2024-03-31 6
40 5281CD VIGAMOX 0.5% EYE DR (NVS/COL) MOXIFLOXACIN 3ML C 27.05 0.5% 0 2022-04-01 2024-03-31 0
41 5281CE VIGAMOX 0.5% EYE DR (NVS) MOXIFLOXACIN (C) 5ML C 45.396 0.5% 0 2024-04-01 2026-03-31 0
42 5281CE VIGAMOX 0.5% EYE DR (NVS) MOXIFLOXACIN 5ML C 45.40 0.5% 0 2026-04-01 No No 0
41 5281CF ENMOX 0.5% EYE DR (SHC) MOXIFLOXACIN (BQ) 5ML BQ 5.7085 0.5% 0 2024-04-01 2026-03-31 0
42 5281CR 4QUIN 0.5% EYE DR (ADO) MOXIFLOXACIN 5ML BQ 6.25 0.5% 0 2026-04-01 No No 0
42 5281CS TOBRACID 0.3% EYE DR (SHC) TOBRAMYCIN 5ML C 2.77 0.3% 2 2026-04-01 No No 6
40 5281P GOTABIOTIC 0.3% EYE DR (LPO/COL) TOBRAMY 5ML BH 7.34 0.3% 0 2022-04-01 2024-03-31 6
41 5281P GOTABIOTIC 0.3% EYE DR (LPO) TOBRAMYCIN (BH) 5ML BH 7.421 0.3% 2 2024-04-01 2026-03-31 6
42 5281P GOTABIOTIC 0.3% EYE DR (LPO) TOBRAMYCIN 5ML C 13.59 0.3% 2 2026-04-01 No No 6
41 5282E APROCIN 0.3% OINT (ARP) CIPROFLOXAC (BH) 3G BH 2.6368 0.3% 0 2024-04-01 2026-03-31 0
42 5282E APROCIN 0.3% OINT (ARP) CIPROFLOXAC 3G BH 2.72 0.3% 0 2026-04-01 No No 0
40 5282F T-MYCIN 0.3% OINT (ARP/AHI) TOBRAMYCIN 3G BH 10.00 0.3% 0 2022-04-01 2022-09-30 0