Displaying 4241 - 4260 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 | 6451AA | MAXITROL 1MG/ML | 3MG/ML | 10,000U EYE DR (NVS/COL) DEXAMETHASONE | NEOMYCIN | P More ... | 5ML | BQ | 32.08 | 1MG/ML|3MG/ML|10000U/ML | 0 | 2022-04-01 | 2024-03-31 | 6 | ||||
| 41 | 6451AE | 4-QUIN D 0.1%|0.5% EYE DR (HAN) DEXAMETHASONE|MOXIFLOXACIN (BQ) | 5ML | BQ | 3.9416 | 0.1%|0.5% | 1 | 2024-04-01 | 2026-03-31 | 6 | ||||
| 40 | 6451L | QUIDEX EYE DROP (LPO/COL) CIPRO/DEXAM | 5ML | B | 8.15 | 0.3%|0.1% | 0 | 2022-04-01 | 2024-03-31 | 6 | ||||
| 41 | 6451L | QUIDEX 0.3%|0.1% EYE DR (LPO) CIPROFLOXACIN|DEXAMETHASONE (BH) | 5ML | BH | 8.9705 | 0.3%|0.1% | 1 | 2024-04-01 | 2026-03-31 | 6 | ||||
| 42 | 6451L | QUIDEX 0.3%|0.1% EYE DR (LPO) CIPROFLOXACIN|DEXAMETHASONE | 5ML | B | 16.31 | 0.3%|0.1% | 1 | 2026-04-01 | No | No | 6 | |||
| 40 | 6451M | MAXISPORIN 1MG/ML | 3MG EYE DR (ASL/PHA) DEXAMETHASONE | NEOMYCIN | POLYMYXIN B | 5ML | BQ | 5.52 | 1MG/ML|3MG/ML|10000U/ML | 0 | 2022-04-01 | 2024-03-31 | 6 | ||||
| 40 | 6451R | GATIDEX 0.1% | 0.3% EYE DR (LPO/COL) DEXAMETHASONE | GATIFLOXACIN | 5ML | BQ | 9.51 | 0.1%|0.3% | 0 | 2022-04-01 | 2024-03-31 | 6 | ||||
| 40 | 6451Y | CIPRODEX 0.3% | 0.1% EAR DR (NVS/COL) CIPROFLOX | 7.5ML | C | 29.68 | 0.3%|0.1% | 0 | 2022-04-01 | 2024-03-31 | 0 | ||||
| 40 | 6451Z | VIGADEXA 0.1% | 0.5% EYE DR (NVS/COL) DEXAMETHA | 5ML | BQ | 20.39 | 0.1%|0.5% | 1 | 2022-04-01 | 2024-03-31 | 6 | ||||
| 41 | 6451Z | VIGADEXA 0.1%|0.5% EYE DR (NVS) DEXAMETHASONE|MOXIFLOXACIN (C) | 5ML | C | 20.3874 | 0.1%|0.5% | 1 | 2024-04-01 | 2026-03-31 | 6 | ||||
| 42 | 6451Z | VIGADEXA 0.1%|0.5% EYE DR (NVS) DEXAMETHASONE|MOXIFLOXACIN | 5ML | C | 20.39 | 0.1%|0.5% | 1 | 2026-04-01 | No | No | 6 | |||
| 41 | 64611 | SULPHADIAZINE 500MG TAB (JOL) SILVER SULPHADIAZINE (C) | 100'S | C | 0.7647 | 500MG | 0 | 2024-04-01 | 2026-03-31 | 0 | ||||
| 42 | 64916 | CALCIUM CHLORIDE 10% INJ (MTP) | 10ML AMP | B | 40.99 | 10% | 0 | 2026-04-01 | No | No | 0 | |||
| 40 | 65216 | PENTAMIDINE 300MG INJ (DIL/AHI) | 10X15ML | C | 641.52 | 300MG | 0 | 2022-04-01 | 2024-03-31 | 0 | ||||
| 40 | 6561D | MESAGUT 400MG TAB (ARP/AHI) MESALAZINE | 30'S | BQ | 0.56 | 400MG | 0 | 2022-04-01 | 2024-03-31 | 6 | ||||
| 42 | 6561D | MESAGUT 400MG TAB (ARP) MESALAZINE | 30'S | BQ | 0.43 | 400MG | 0 | 2026-04-01 | No | No | 0 | |||
| 40 | 6561G | PENTASA 500MG TAB (FER/STO) MESALAZINE | 50'S | BQ | 1.78 | 500MG | 0 | 2022-04-01 | 2024-03-31 | Package Size Change | 6 | |||
| 41 | 6561G | PENTASA 500MG TAB (FER) MESALAZINE | 50'S | BQ | 1.9099 | 500MG | 0 | 2024-04-01 | 2026-03-31 | 0 | ||||
| 42 | 6561G | PENTASA 500MG TAB (FER) MESALAZINE | 50'S | BQ | 2.14 | 500MG | 0 | 2026-04-01 | No | No | 0 | |||
| 40 | 65712 | CLOZAPINE 25MG TAB (APL/AHI) | 100'S | BP | 0.97 | 25MG | 270 | 2022-04-01 | 2022-07-30 | 6 | ||||