Displaying 341 - 360 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 0301S CLINDAMYCIN PHOSPHATE 150MG/ML INJ (FSB) (B) 10X2ML B 2.9956 150MG/ML 112 2024-04-01 2026-03-31 0
40 0302AA LACLIDA 150MG/ML INJ (LDP/AHI) CLINDAMYCIN PH 10X4ML BQ 7.99 150MG/ML 0 2022-04-01 2024-03-31 6
41 0302AB CLINDAMYCIN PHOSPHATE 150MG/ML INJ (FSB) (B) 10X4ML B 5.1702 150MG/ML 0 2024-04-01 2026-03-31 0
42 0302AC CLINDAMYCIN PHOSPHATE 150MG/ML INJ (BAX) 10X4ML BQ 1.90 150MG/ML 0 2026-04-01 No No 0
40 0314B FUSIDIC ACID DRESSING 1% (LDP/AHI) 10'S A 19.14 1% 10 2022-04-01 2024-03-31 0
41 0314B FUSIDIC ACID DRESSING 1% DRESSING (LDP) 10'S A 1.8974 1% 10 2024-04-01 2026-03-31 6
42 0314B FUSIDIC ACID DRESSING 1% DRESSING (LDP) 10'S A 1.90 1% 10 2026-04-01 No No Add to Contract as Cat A 6
40 0314L BACTIGRAS 10CMX10CM (SMN/IMS) CHLORHEXIDINE 10'S A 2.90 10CMX10CM 10 2022-04-06 2024-03-31 Add to Contract as Cat A 6
41 0314L BACTIGRAS 10CMX10CM (SMN) CHLORHEXIDINE 10'S A 3.175 0.5% 10 2024-04-01 2026-03-31 0
40 0321AB GENTAMICIN 40MG/ML IV/IM INJ (RTM/PHA) 10X2ML B 1.25 40MG/ML IV/IM 0 2022-04-01 2022-05-31 6
40 0321AB GENTAMICIN 40MG/ML IV/IM INJ (RTM/PHA) 10X2ML B 1.93 40MG/ML IV/IM 0 2022-06-01 2024-03-31 Price Change 6
41 0321AB GENTAMICIN 40MG/ML IV/IM INJ (RTM) (B) 10X2ML B 1.4896 40MG/ML IV/IM 0 2024-04-01 2026-03-31 0
42 0321AB GENTAMICIN 40MG/ML IV/IM INJ (RTM) 10X2ML B 1.09 40MG/ML IV/IM 0 2026-04-01 No No 0
40 0321AX GENTASHIP 40MG/ML IV/IM INJ (FSB/ATB) GENTAMI 10X2ML B 0.54 40MG/ML IV/IM 0 2022-04-01 2022-07-11 6
40 0321AX GENTASHIP 40MG/ML IV/IM INJ (FSB/ATB) GENTAMI 10X2ML B 0.67 40MG/ML IV/IM 0 2022-07-12 2024-03-31 Price Change 6
42 0321BD GENTACURE 40MG/ML IV/IM INJ (JLP) GENTAMICIN 100X2ML B 0.79 40MG/ML IV/IM 0 2026-04-01 No No 0
40 03248 GENOPTIC 0.3% EYE DR (ASL/PHA) GENTAMICIN 5ML BQ 4.08 0.3% 1 2022-04-01 2024-03-31 6
41 03248 GENOPTIC 0.3% EYE DR (ASL) GENTAMICIN 5ML BQ 7.3395 0.3% 1 2024-04-01 2026-03-31 0
42 03248 GENOPTIC 0.3% EYE DR (ASL) GENTAMICIN 5ML B 6.63 0.3% 1 2026-04-01 No No 0
40 03267 GENTAMICIN 0.3% EYE OINT (AKI/AHI) 3.5G C 156.87 0.3% 0 2022-04-01 2024-03-31 0