Displaying 4421 - 4440 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 6712C AVELOX 400MG INJ (BSP) MOXIFLOXACIN 250ML C 32.05 400MG 0 2026-04-01 No No 0
41 6712CC LEVOFLOX DENK 5MG/ML INJ (EDK) LEVOFLOXACIN (BQ) 100ML BQ 14.8149 5MG/ML 14 2024-04-01 2026-03-31 0
41 6712CD LEVOFLOX DENK 5MG/ML INJ (EDK) LEVOFLOXACIN (BQ) 100ML BQ 15.6304 5MG/ML 14 2024-04-01 2026-03-31 0
42 6712CF GLEVO 5MG/ML INJ (GLP) LEVOFLOXACIN 100ML B 6.80 5MG/ML 14 2026-04-01 No No 0
42 6712CG GLEVO 5MG/ML INJ (GLP) LEVOFLOXACIN 100ML B 6.60 5MG/ML 14 2026-04-01 No No 0
42 6712CH MOXIGET 400MG INJ (GET) MOXIFLOXACIN 10ML BQ 8.73 400MG 0 2026-04-01 No No 0
40 6712T AVELOX 400MG INJ (BSP/AHI) MOXIFLOXACIN 250ML C 50.70 400MG 0 2022-04-01 2024-03-31 0
41 6712T AVELOX 400MG INJ (BSP) MOXIFLOXACIN (C) 250ML C 50.6967 400MG 0 2024-04-01 2026-03-31 0
42 6712T AVELOX 400MG INJ (BSP) MOXIFLOXACIN 250ML C 35.20 400MG 0 2026-04-01 No No 0
41 6712U CIPROXINA 400MG INJ (BSP) CIPROFLOXACIN (C) 200ML C 70.6764 20MG/ML 0 2024-04-01 2026-03-31 0
40 6712V CIPROXINA 200MG INJ (BSP/AHI) CIPROFLOXACIN 100ML C 55.73 200MG 0 2022-04-01 2024-03-31 0
41 6712V CIPROXINA 200MG INJ (BSP) CIPROFLOXACIN (C) 100ML C 55.7256 200MG 56 2024-04-01 2026-03-31 0
42 6712V CIPROXINA 200MG INJ (BSP) CIPROFLOXACIN 100ML C 38.74 200MG 56 2026-04-01 No No 0
40 67325 ULTRAVIST 300MG/ML INJ (BSP/AHI) IOPROMIDE 50ML BQ 34.31 300MG/ML 0 2022-04-01 2024-03-31 0
41 67325 ULTRAVIST 300MG/ML INJ (BSP) IOPROMIDE (BQ) 50ML BQ 37.4585 300MG/ML 7 2024-04-01 2026-03-31 0
42 67325 ULTRAVIST 300MG/ML INJ (BSP) IOPROMIDE 50ML BQ 37.46 300MG/ML 7 2026-04-01 No No 0
40 6732T ULTRAVIST 300 INJ (BSP/COL) IOPROMIDE 50ML BQ 34.31 300MG/ML 0 2022-04-01 2024-03-31 0
41 6732T ULTRAVIST 300 INJ (BSP) IOPROMIDE (BQ) 50ML BQ 37.4585 300MG/ML 0 2024-04-01 2026-03-31 0
42 6732T ULTRAVIST 300 INJ (BSP) IOPROMIDE 50ML BQ 34.09 300MG/ML 0 2026-04-01 No No 0
40 6732U ULTRAVIST 300 INJ (BSP/COL) IOPROMIDE 100ML BQ 68.61 300MG/ML 0 2022-04-01 2024-03-31 0