Displaying 4461 - 4480 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 67351 ULTRAVIST 370 INJ (BSP) IOPROMIDE (BQ) 100ML BQ 112.593 370MG/ML 7 2024-04-01 2026-03-31 0
42 67351 ULTRAVIST 370 INJ (BSP) IOPROMIDE 100ML BQ 112.59 370MG/ML 7 2026-04-01 No No 0
40 67358 ULTRAVIST 370 INJ (BSP/COL) IOPROMIDE 100ML BQ 103.05 370MG/ML 0 2022-04-01 2024-03-31 0
41 67358 ULTRAVIST 370 INJ (BSP) IOPROMIDE (BQ) 100ML BQ 112.593 370MG/ML 7 2024-04-01 2026-03-31 0
42 67358 ULTRAVIST 370 INJ (BSP) IOPROMIDE 100ML BQ 102.45 370MG/ML 7 2026-04-01 No No 0
40 6735E XULVARIO 350MG/ML INJ (UNI/AHI) IOHEXOL 100ML BQ 55.62 350MG/ML 0 2022-04-01 2024-03-31 0
40 6781R ETOPOSIDE 20MG/ML INJ (INP/AHI) 5ML VIAL BQ 17.21 20MG/ML 0 2022-04-01 2024-03-31 0
41 6781W ZUVITOP 20MG/ML INJ (ZUV) ETOPOSIDE 5ML VIAL BQ 12.2868 20MG/ML 40 2024-04-01 2026-03-31 0
42 6781Y POSID 20MG/ML INJ (CAD) ETOPOSIDE 5ML VIAL BQ 8.75 20MG/ML 40 2026-04-01 No No 0
41 67827 ZUVITOP 50MG CAP (ZUV) ETOPOSIDE 20'S BQ 1.6092 50MG 10 2024-04-01 2024-05-17 6
41 67828 ZUVITOP 50MG TAB (ZUV) ETOPOSIDE 8'S BQ 3.2925 50MG 10 2024-04-05 2026-03-31 6
42 67828 ZUVITOP 50MG TAB (ZUV) ETOPOSIDE 8'S BQ 3.00 50MG 0 2026-04-01 No No 0
40 67911 PHARIXIA 0.15% RINSE (PMS/COL) BENZYDAMINE 250ML BQ 8.83 0.15% 0 2022-04-01 2024-03-31 0
41 67911 PHARIXIA 0.15% RINSE (PMS) BENZYDAMINE 250ML BQ 13.9994 0.15% 0 2024-04-01 2026-03-31 0
42 67911 PMS-BENZYDAMINE 0.15% RINSE (PMS) 250ML B 9.51 0.15% 0 2026-04-01 No No 0
40 6801F ZEVERT 8MG TAB (INP/AHI) BETAHISTINE 120'S A 0.07 8MG 90 2022-04-01 2024-03-31 6
40 6801G BETASERC 16MG TAB (ABB/PHA) BETAHISTINE 20'S C 0.63 16MG 0 2022-04-01 2024-03-31 0
40 6801G BETASERC 16MG TAB (ABB/PHA) BETAHISTINE (C) 20'S C 0.628 16MG 2022-04-01 2023-03-31 No No Delete from contract 0
41 6801H ZEVERT 16MG TAB (INP) BETAHISTINE 5X10 A 0.1577 16MG 90 2024-04-01 2026-03-31 6
42 6801M VERTILINE 16MG TAB (JLP) BETAHISTINE 10X10 A 0.07 16MG 90 2026-04-01 No No 6