Displaying 4441 - 4460 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 6732U ULTRAVIST 300 INJ (BSP) IOPROMIDE (BQ) 100ML BQ 74.9714 300MG/ML 0 2024-04-01 2026-03-31 0
42 6732U ULTRAVIST 300 INJ (BSP) IOPROMIDE 100ML BQ 68.23 300MG/ML 0 2026-04-01 No No 0
40 6732V ULTRAVIST 300 INJ (BSP/AHI) IOPROMIDE 100ML BQ 68.61 300MG/ML 0 2022-04-01 2024-03-31 0
41 6732V ULTRAVIST 300 INJ (BSP) IOPROMIDE (BQ) 100ML BQ 74.9714 300MG/ML 0 2024-04-01 2026-03-31 0
42 6732V ULTRAVIST 300 INJ (BSP) IOPROMIDE 100ML BQ 74.97 300MG/ML 0 2026-04-01 No No 0
40 6732Z CONTRAPAQUE 300MG/ML INJ (UNI/AHI) IOHEXOL 50ML BQ 42.70 300MG/ML 0 2022-04-01 2024-03-31 0
40 6734AC GADOVIST 604MG/ML INJ (BSP/AHI) GADOBUTROL 7.5ML BQ 135.43 604MG/ML 0 2022-04-01 2024-03-31 0
41 6734AC GADOVIST 604MG/ML INJ (BSP) GADOBUT (C) 7.5ML C 135.7259 604MG/ML 0 2024-04-01 2026-03-31 0
42 6734AC GADOVIST 604MG/ML INJ (BSP) GADOBUT 7.5ML C 135.73 604MG/ML 0 2026-04-01 No No 0
40 6734AQ CONTRAPAQUE 350MG/ML INJ (UNI/AHI) IOHEXOL 50ML BQ 43.06 350MG/ML 0 2022-04-01 2024-03-31 0
40 6734Q ULTRAVIST 370 INJ (BSP/COL) IOPROMIDE 50ML BQ 46.76 370MG/ML 0 2022-04-01 2024-03-31 0
41 6734Q ULTRAVIST 370 INJ (BSP) IOPROMIDE (BQ) 50ML BQ 51.0773 370MG/ML 7 2024-04-01 2026-03-31 0
42 6734Q ULTRAVIST 370 INJ (BSP) IOPROMIDE 50ML BQ 51.27 370MG/ML 7 2026-04-01 No No 0
40 6734R ULTRAVIST 370 INJ (BSP/AHI) IOPROMIDE 50ML BQ 46.76 370MG/ML 0 2022-04-01 2024-03-31 0
41 6734R ULTRAVIST 370 INJ (BSP) IOPROMIDE (BQ) 50ML BQ 51.0773 370MG/ML 7 2024-04-01 2026-03-31 0
42 6734R ULTRAVIST 370 INJ (BSP) IOPROMIDE 50ML BQ 56.32 370MG/ML 7 2026-04-01 No No 0
40 6734Z GADOVIST 604MG/ML INJ (BSP/COL) GADOBUTROL 7.5ML BQ 135.43 604MG/ML 0 2022-04-01 2024-03-31 0
41 6734Z GADOVIST 604MG/ML INJ (BSP) GADOBUTROL (C) 7.5ML C 135.7259 604MG/ML 0 2024-04-01 2026-03-31 0
42 6734Z GADOVIST 604MG/ML INJ (BSP) GADOBUTROL 7.5ML C 123.52 604MG/ML 0 2026-04-01 No No 0
40 67351 ULTRAVIST 370 INJ (BSP/AHI) IOPROMIDE 100ML BQ 103.05 370MG/ML 0 2022-04-01 2024-03-31 0