Displaying 4761 - 4780 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 7722CM ACUCLAV 500MG/125MG TAB (MCP/AHI) 20's B $0.177 500MG / 125MG 21 2023-06-06 2024-03-31 B
41 7722CM ACUCLAV 500MG|125MG TAB (MCP) AMOXICILLIN|CLAVULANIC ACID (B) 2X10 B 0.2596 500MG|125MG 30 2024-04-01 2026-03-31 0
42 7722CM ACUCLAV 500MG|125MG TAB (MCP) AMOXICILLIN|CLAVULANIC ACID 2X10 B 0.28 500MG|125MG 30 2026-04-01 No No 0
40 7722CP AMOXICILLIN | CLAVULANIC ACID 875MG | 125MG TAB (MCP/AHI) 2X10 B 0.36 875MG|125MG 21 2022-04-01 2024-03-31 6
41 7722CP AMOXICILLIN|CLAVULANIC ACID 875MG|125MG TAB (MCP) (B) 2X10 B 0.3833 875MG|125MG 21 2024-04-01 2024-12-27 0
41 7722CP AMOXICILLIN|CLAVULANIC ACID 875MG|125MG TAB (MCP) (B) 2X10 B 0.4045 875MG|125MG 21 2024-12-28 2026-03-31 0
41 7722CW APO-AMOXYCLAV 875MG|125MG TAB (APO) (B) 100'S B 0.3504 875MG|125MG 21 2024-04-01 2026-03-31 0
40 7722D AUGMENTIN 500MG | 125MG TAB (GSK/COL) AMOXICILLIN | CLAVULANIC ACID 14'S C 1.19 500MG|125MG 0 2022-04-01 2024-03-31 0
41 7722D AUGMENTIN 500MG|125MG TAB (GSK) AMOXICILLIN|CLAVULANIC ACID (B) 14'S B 1.3087 500MG|125MG 30 2024-04-01 2026-03-31 0
42 7722D AUGMENTIN 500MG|125MG TAB (GSK) AM (C) 14'S C 1.44 500MG|125MG 30 2026-04-01 No No 0
42 7722DQ AMOXICILLIN|CLAVULANIC ACID 875MG|125MG TAB (KWA) 2X10 B 0.33 875MG|125MG 21 2026-04-01 No No Add to Contract as Cat B 0
42 7722DR AMOXICILLIN|CLAVULANIC ACID 500MG|125MG TAB (KWA) 20'S B 0.25 500MG|125MG 30 2026-04-01 No No Add to Contract as Cat B 0
40 7722E AUGMENTIN 875MG | 125MG TAB (GSK/COL) AMOXICILLIN | CLAVULANIC ACID 14'S C 1.91 875MG|125MG 0 2022-04-01 2024-03-31 0
41 7722E AUGMENTIN 875MG|125MG TAB (GSK) AMOXICILLIN|CLAVULANIC ACID (B) 14'S B 2.1009 875MG|125MG 21 2024-04-01 2026-03-31 0
42 7722E AUGMENTIN 875MG|125MG TAB (GSK) AM (C) 14'S C 2.32 875MG|125MG 21 2026-04-01 No No 0
40 77239 AUGMENTIN 40MG/ML | 5.6MG/ML SUSP (GSK/COL) AMOXICILLIN | CLAVULANIC ACID 70ML C 0.16 40MG/ML|5.6MG/ML 0 2022-04-01 2024-03-31 0
41 77239 AUGMENTIN 40MG/ML|5.6MG/ML SUSP (GSK) AMOXICILLIN|CLAVULANIC (C) 70ML C 0.1794 40MG/ML|5.6MG/ML 140 2024-04-01 2026-03-31 0
42 77239 AUGMENTIN 40MG/ML|5.6MG/ML SUSP (GSK) AMOXICILLIN|CLAVULANIC 70ML B 0.20 40MG/ML|5.6MG/ML 140 2026-04-01 No No 0
41 7723Z AMOXICILLIN|CLAVULANIC ACID 40MG/ML|5.6MG/ML SUSP (THE) (B) 100ML B 0.0636 40MG/ML|5.6MG/ML 140 2024-04-01 2026-03-31 0
40 77249 AUGMENTIN 80MG/ML | 11.4MG/ML SUSP (GSK/COL) AMOXICILLIN | CLAVULANIC ACID 70ML C 0.14 80MG/ML|11.4MG/ML 0 2022-04-01 2024-03-31 0