Displaying 3661 - 3680 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 5591A CERUMOL EAR DR (THR/SBI) PROPYLENE GLYCOL | TU 11ML A 4.35 |10% 1 2022-04-01 2024-03-31 6
41 5591B WAXONIL 2%|15% EAR DR (SPC) PARADICHLOROBENZENE|TURPENTINE O 10ML BOTT A 6.4424 2%|15% 1 2024-04-01 2026-03-31 6
42 5591B WAXONIL 2%|15% EAR DR (SPC) PARADICHLOROBENZENE|TURPENTINE O 10ML A 6.80 2%|15% 1 2026-04-01 No No 6
42 5591C SOLYEAR 8.4% EAR DR (JLP) PARADICHLOROBENZENE 10ML A 5.44 8.4% 1 2026-04-01 No No 6
40 5621D DERMOVATE 0.05% CR (GSK/COL) CLOBETASOL 30G C 23.92 0.05% 0 2022-04-01 2024-03-31 0
41 5621D DERMOVATE 0.05% CR (GSK) CLOBETASOL (C) 30G C 26.3134 0.05% 0 2024-04-01 2026-03-31 0
42 5621D DERMOVATE 0.05% CR (GSK) CLOBETASOL 30G C 28.95 0.05% 0 2026-04-01 No No 0
40 5621E DERMOVATE 0.05% OINT (GSK/COL) CLOBETASOL 30G C 23.92 0.05% 0 2022-04-01 2024-03-31 0
41 5621E DERMOVATE 0.05% OINT (GSK) CLOBETASOL (C) 30G C 26.3134 0.05% 0 2024-04-01 2026-03-31 0
42 5621E DERMOVATE 0.05% OINT (GSK) CLOBETASOL 30G C 28.95 0.05% 0 2026-04-01 No No 0
40 5621P CLOBETASOL 0.05% LOT (CHC/ATB) 60ML C 6.96 0.05% 0 2022-04-01 2024-03-31 0
40 56222 CLOBETASOL 0.05% SHAMP (WOC/AHI) 50ML C 70.68 0.05% 0 2022-04-01 2024-03-31 0
41 56223 CLOBETASONE 0.05% SHAMP (GLP) CLOB (C) 100ML C 48.93 0.05% 1 2024-04-01 2026-03-31 0
41 5641AK ROCEPHIN 1G IV INJ (ROC) CEFTRIAXONE (C) 1G VIAL C 12.2325 1G IV 28 2024-04-01 2026-03-31 0
42 5641AK ROCEPHIN 1G IV INJ (ROC) CEFTRIAXONE 1G VIAL C 12.23 1G IV 28 2026-04-01 No No 0
40 5641BS C ZID 1G INJ (EMC/COL) CEFTAZIDIME 1G VIAL B 4.08 1G 0 2022-04-01 2024-03-31 6
41 5641BS C ZID 1G INJ (EMC) CEFTAZIDIME (B) 1G VIAL B 6.7958 1G 28 2024-04-01 2026-03-31 0
42 5641BS C ZID 1G INJ (EMC) CEFTAZIDIME 1G VIAL B 8.70 1G 28 2026-04-01 No No 0
40 5641BT C TRI 1G IV/IM INJ (EMC/COL) CEFTRIAXONE 1G VIAL C 2.99 1G IV/IM 0 2022-04-01 2024-03-31 0
41 5641BT C TRI 1G IV/IM INJ (EMC) CEFTRIAXONE (C) 1G VIAL C 4.893 1G IV/IM 28 2024-04-01 2026-03-31 0