Displaying 3501 - 3520 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 5282F T-MYCIN 0.3% OINT (ARP) TOBRAMYCIN (BH) 3G BH 5.3823 0.3% 2 2024-04-01 2026-03-31 6
40 5282G TOBREX 0.3% EYE OINT (NVS/COL) TOBRAMYCIN 3.5G BH 15.49 0.3% 0 2022-04-01 2024-03-31 6
41 5282G TOBREX 0.3% EYE OINT (NVS) TOBRAMYC (C) 3.5G C 15.4944 0.3% 2 2024-04-01 2026-03-31 6
42 5282G TOBREX 0.3% EYE OINT (NVS) TOBRAMYC 3.5G C 15.49 0.3% 2 2026-04-01 No No 6
42 5282J TOBRACID 0.3% EYE OINT (HAN) TOBRAMYCIN 3G BH 2.80 0.3% 2 2026-04-01 No No 0
41 53013 ASPIRIN|DIPYRIDAMOLE 25MG|200MG ER (C) 60'S C 1.7216 25MG|200MG 0 2024-04-01 2026-03-31 0
40 53116 PENICILLAMINE 250MG CAP (SLS/AHI) 50'S A 3.01 250MG 180 2022-04-01 2024-03-31 6
41 53117 PENICILLAMINE 250MG CAP (JOL) 50'S A 1.4097 250MG 180 2024-04-01 2026-03-31 6
42 53117 PENICILLAMINE 250MG CAP (JOL) 50'S A 0.93 250MG 180 2026-04-01 No No 6
41 5422G TOBRAMYCIN 40MG/ML INJ (DIL) (BQ) 25X2ML BQ 19.2958 40MG/ML 0 2024-04-01 2026-03-31 0
40 5422J TOCIN 40MG/ML INJ (UBI/RXP) TOBRAMYCIN 2ML VIAL BQ 8.97 40MG/ML 0 2022-04-01 2024-03-31 6
41 54814 TINIREM 500MG TAB (REM) TINIDAZOLE 10X4 A 0.2209 500MG 8 2024-04-01 2026-03-31 0
42 54814 TINIREM 500MG TAB (REM) TINIDAZOLE 10X4 A 0.22 500MG 14 2026-04-01 No No 0
40 5481Q TINIDAZOLE 500MG TAB (LAF/AHI) 40'S A 0.97 500MG 8 2022-04-01 2024-03-31 Change Local Agent 0
40 55011 AROMASIN 25MG TAB (PFI/STO) EXEMESTANE 30'S C 8.66 25MG 0 2022-04-01 2024-03-31 0
41 55011 AROMASIN 25MG TAB (PFI) EXEMESTANE (C) 30'S C 8.6588 25MG 30 2024-04-01 2026-03-31 6
42 55011 AROMASIN 25MG TAB (PFI) EXEMESTANE 30'S C 8.66 25MG 30 2026-04-01 No No 6
41 55015 EXEMESTANE 25MG TAB (REM) (BQ) 30'S BQ 0.3842 25MG 30 2024-04-01 2026-03-31 6
42 55015 EXEMESTANE 25MG TAB (REM) 30'S BQ 0.61 25MG 30 2026-04-01 No No 0
40 55018 EXETAS 25MG TAB (INP/AHI) EXEMESTANE 3X10 BQ 7.44 25MG 0 2022-04-01 2024-03-31 6