Displaying 4281 - 4300 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
42 6581S ZOLADEX 3.6MG KIT (AZN) GOSERELIN 3.6MG KIT BQ 205.51 3.6MG 0 2026-04-01 No No 0
42 6591F DOBUTAMINE 12.5MG/ML INJ (RTM) 10X20ML BQ 4.08 12.5MG/ML 30 2026-04-01 No No 0
41 6591P DOBUTAMINE 12.5MG/ML INJ (SLS) (BQ) 20ML BQ 9.7316 12.5MG/ML 30 2024-04-01 2026-03-31 6
40 6591R DOBUTAMINE 12.5MG/ML INJ (RTM/PHA) 20ML BQ 6.03 12.5MG/ML 0 2022-04-01 2024-03-31 0
41 6591R DOBUTAMINE 12.5MG/ML INJ (RTM) (BQ) 20ML BQ 11.4713 12.5MG/ML 30 2024-04-01 2026-03-31 6
40 6591V LABUTAMINE 12.5MG/ML INJ (LDP/AHI) DOBUTAMINE 20ML BQ 8.07 12.5MG/ML 0 2022-04-01 2024-03-31 0
41 66311 DIPRIVAN 10MG/ML INJ (ASG) PROPOFOL (C) 5X20ML C 14.7822 10MG/ML 30 2024-04-01 2026-03-31 0
40 66318 PROPOFOL 10MG/ML INJ (BRA/COL) 5X20ML BQ 2.78 10MG/ML 0 2022-04-01 2024-03-31 0
41 66318 PROPOFOL 10MG/ML INJ (BRA) (BQ) 5X20ML BQ 3.7948 10MG/ML 30 2024-04-01 2026-03-31 0
42 66318 PROPOFOL 10MG/ML INJ (BRA) 5X20ML BQ 4.89 10MG/ML 30 2026-04-01 No No 0
40 6631A PROPOFOL 10MG/ML INJ (BRA/COL) 50ML BQ 8.13 10MG/ML 0 2022-04-01 2024-03-31 0
41 6631A PROPOFOL 10MG/ML INJ (BRA) (BQ) 50ML BQ 8.1278 10MG/ML 30 2024-04-01 2026-03-31 0
42 6631A PROPOFOL 10MG/ML INJ (BRA) 50ML BQ 11.42 10MG/ML 30 2026-04-01 No No 0
41 6631L PROPOFOL 10MG/ML INJ (KWA) (BQ) 20ML BQ 3.561 10MG/ML 30 2024-04-01 2026-03-31 0
40 6631Q PROPOFOL 10MG/ML INJ (BAX/STO) 5X20ML C 6.65 10MG/ML 0 2022-04-01 2024-03-31 0
40 6631R OLEO-LAX 10MG/ML INJ (ABB/PHA) PROPOFOL 5X20ML C 8.83 10MG/ML 0 2022-04-01 2024-03-31 0
40 6631R OLEO-LAX 10MG/ML (ABB/PHA) PROPOFOL (C) 5X20ML C 8.834 10MG/ML 2022-04-01 2023-03-31 No No Delete from contract 0
42 6631Y PROPIFOL 10MG/ML INJ (JLP) PROPOFOL 20X20ML BQ 1.79 10MG/ML 0 2026-04-01 No No 0
40 66511 INALIX SR 1.5MG TAB (HEA/RXP) INDAPAMIDE 3X10 C 0.10 1.5MG 0 2022-04-01 2024-03-31 0
40 6651A NATRILIX SR 1.5MG TAB (SER/STO) INDAPAMIDE 30'S A 0.20 1.5MG 30 2022-04-01 2024-03-31 6