Displaying 441 - 460 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
40 05616 CHLORAMBUCIL 2MG TAB (KWA/ATB) 3X10 A 5.89 2MG 240 2022-05-27 2024-03-31 Package Size Change 6
42 05618 CHLORAMBUCIL 2MG TAB (FSB) 25'S A 16.31 2MG 240 2026-04-01 No No 6
40 05743 ENDOXAN 50MG TAB (BAX/STO) CYCLOPHOSPHAMIDE 50'S B 0.02 50MG 0 2022-04-01 2024-03-31 0
41 05743 ENDOXAN 50MG TAB (BAX) CYCLOPHOSPHAMIDE 50'S A 0.0266 50MG 240 2024-04-01 2026-03-31 6
42 05743 ENDOXAN 50MG TAB (BAX) CYCLOPHOSPHA 50'S BQ 0.07 50MG 240 2026-04-01 No No 0
40 05752 ENDOXAN 1G INJ (ASM/COL) CYCLOPHOSPHAMIDE 1G VIAL BQ 38.06 1G 0 2022-04-01 2024-03-31 0
40 05756 ENDOXAN 1G INJ (BAX/STO) CYCLOPHOSPHAMIDE 1G VIAL BQ 15.96 1G 0 2022-04-01 2024-03-31 0
41 05756 ENDOXAN 1G INJ (BAX) CYCLOPHOSPHAMIDE (BQ) 1G VIAL BQ 17.3429 1G 30 2024-04-01 2026-03-31 6
42 05756 ENDOXAN 1G INJ (BAX) CYCLOPHOSPHAMIDE 1G VIAL BQ 22.40 1G 30 2026-04-01 No No 0
41 0575F CYCLOPHOSPHAMIDE 1G INJ (KWA) (BQ) 1G VIAL BQ 10.4112 1G 30 2024-04-01 2026-03-31 6
41 05814 CYTARABINE 100MG INJ (ZUV) (BQ) 100MG VIAL BQ 7.4754 100MG 100 2024-04-01 2026-03-31 6
42 05814 CYTARABINE 100MG INJ (ZUV) 100MG VIAL BQ 11.12 100MG 100 2026-04-01 No No 0
41 0581D CYTARABINE 100MG INJ (KWA) (BQ) 100MG VIAL BQ 5.5454 100MG 100 2024-04-01 2026-03-31 6
40 0582B CYTARABINE 1G INJ (INP/AHI) 1G VIAL BQ 38.46 1G 0 2022-04-01 2024-03-31 0
40 0582D ONCOTAR 1G INJ (UBI/RXP) CYTARABINE 1G VIAL BQ 31.26 1G 0 2022-04-01 2024-03-31 0
41 0582E CYTRAZ 1G INJ (ZUV) CYTARABINE (BQ) 1G VIAL BQ 20.6864 100MG 0 2024-04-01 2026-03-31 0
42 0582E CYTRAZ 100MG INJ (ZUV) CYTARABINE 1G VIAL BQ 16.80 100MG 0 2026-04-01 No No 0
40 06032 FLUOROURACIL 50MG/ML INJ (EBA/COL) 10ML BQ 26.48 50MG/ML 0 2022-04-01 2024-03-31 0
41 0603B FLUOROURACIL 50MG/ML INJ (DIL) (BQ) 10X10ML BQ 12.6973 50MG/ML 0 2024-04-01 2026-03-31 0
41 0603D FLUOROURACIL 50MG/ML INJ (SLS (BQ) 10ML BQ 18.6749 50MG/ML 0 2024-04-01 2026-03-31 0