Displaying 4541 - 4560 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 7151AM CASODEX 150MG TAB (AZN) BICALUTAMID 28'S C 23.39 150MG 0 2026-04-01 No No 0
40 7151AN CASODEX 50MG CAP (AZN/COL) BICALUTAMIDE 28'S C 8.08 50MG 0 2022-04-01 2024-03-31 0
41 7151AN CASODEX 50MG CAP (AZN) BICALUTAMIDE (C) 28'S C 8.0822 50MG 0 2024-04-01 2026-03-31 0
42 7151AN CASODEX 50MG CAP (AZN) BICALUTAMIDE 28'S C 8.08 50MG 0 2026-04-01 No No 0
40 7151AW AAP-FLUTAMIDE 250MG TAB (APO/COL) FLUTAMIDE 100'S A 0.33 250MG 180 2022-04-01 2024-03-31 6
40 7151P APO-BICALUTAMIDE 50MG TAB (APO/COL) 30'S C 0.59 50MG 0 2022-04-01 2024-03-31 0
40 7151R BICALUTAMIDE 150MG TAB (CIP/AHI) 30'S C 3.11 150MG 0 2022-04-01 2024-03-31 0
41 7151S BICALUTAMIDE 50MG TAB (CIP) (C) 30'S C 0.589 50MG 0 2024-04-01 2026-03-31 0
40 72017 METALYSE 50MG INJ (BOE/STO) TENECTEPLASE 50MG VIAL BQ 2,535.76 50MG 0 2022-04-01 2024-03-31 0
41 72017 METALYSE 50MG INJ (BOE) TENECTEPLASE (BQ) 50MG VIAL BQ 2872.9966 50MG 0 2024-04-01 2026-03-31 0
42 72017 METALYSE 50MG INJ (BOE) TENECTEPLASE 50MG VIAL BQ 2,873.00 50MG 0 2026-04-01 No No 0
42 7201N ELAXIM 50MG INJ (EMC) TENECTEPLASE 50MG VIAL BQ 1,902.83 50MG 0 2026-04-01 No No 0
40 72211 BETAFERON 8MU/ML INJ (BSP/AHI) INTERFERON BET 15X3ML C 2,786.28 8MU/ML 0 2022-04-01 2024-03-31 0
42 72211 BETAFERON 8MU/ML INJ (BSP) INTERFERON B1 15X3ML BQ 2,721.04 8MU/ML 0 2026-04-01 No No 0
40 72212 AVONEX 30MCG/ML INJ (BGN/PHA) INTERFERON BETA 1A 4X30MCG C 2,560.66 30MCG/ML 0 2022-04-01 2024-03-31 0
41 72212 AVONEX 30MCG/ML INJ (BGN) INTERFERON BETA 1A (BQ) 4X30MCG BQ 2611.8744 30MCG/ML 0 2024-04-01 2026-03-31 0
40 72218 BETAFERON 8MU/ML INJ (BSP/COL) INTERFERON BET 15X3ML C 2,786.28 8MU/ML 0 2022-04-01 2024-03-31 0
41 72218 BETAFERON 8MU/ML INJ (BSP) INTERFERON B1 (C) 15X3ML C 2786.2821 8MU/ML 0 2024-04-01 2026-03-31 0
42 72218 BETAFERON 8MU/ML INJ (BSP) INTERFERON B1 15X3ML BQ 2,476.15 8MU/ML 0 2026-04-01 No No 0
40 72416 MANGANESE 0.1 MG/ML INJ (KWA/ATB) 10ML BQ 25.04 0.1 MG/ML 0 2022-04-01 2024-03-31 0