Displaying 4901 - 4920 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 A033AQ GRANI-DENK 1MG/ML INJ (EDK) GRANISE (BQ) 5X1ML BQ 2.8325 1MG/ML 6 2024-04-01 2026-03-31 6
42 A033AQ GRANI-DENK 1MG/ML INJ (EDK) GRANISE 5X1ML BQ 2.99 1MG/ML 6 2026-04-01 No No 0
40 A033AW GRANICIP 1MG/ML INJ (TPP/AHI) GRANISETRON 3ML VIAL BQ 6.25 1MG/ML 0 2022-04-01 2024-03-31 0
41 A033AW GRANICIP 1MG/ML INJ (TPP) GRANISETR (BQ) 3ML VIAL BQ 6.2521 1MG/ML 6 2024-04-01 2026-03-31 6
42 A033AW GRANICIP 1MG/ML INJ (TPP) GRANISETR 3ML VIAL BQ 6.47 1MG/ML 6 2026-04-01 No No 0
42 A033AX GRANI-DENK 1MG/ML INJ (EDK) GRANISETRON 5X1ML BQ 2.99 1MG/ML 6 2026-04-01 No No 0
40 A0411 CELLCEPT 500MG CAP (ROC/AHI) MYCOPHENOLATE 50'S BQ 3.81 500MG 0 2022-04-01 2024-03-31 6
41 A0411 CELLCEPT 500MG CAP (ROC) MYCOPHENOL (C) 50'S C 3.8057 500MG 180 2024-04-01 2026-03-31 6
42 A0411 CELLCEPT 500MG CAP (ROC) MYCOPHENOL 50'S BQ 3.81 500MG 180 2026-04-01 No No 0
40 A0412 MYFORTIC 360MG CAP (NVS/COL) MYCOPHENOLATE 120'S C 5.35 360MG 0 2022-04-01 2024-03-31 0
41 A0412 MYFORTIC 360MG CAP (NVS) MYCOPHENOLATE (C) 120'S C 5.346 360MG 240 2024-04-01 2026-03-31 6
41 A041L APO-MYCOPHENOLATE 500MG TAB (APO) (BQ) 50'S BQ 1.0205 500MG 180 2024-04-01 2026-03-31 0
41 A041N MYCOPHENOLATE 360MG TAB (INP) (C) 50'S C 4.4852 360MG 0 2024-04-01 2026-03-31 0
41 A041Q MOFILET 500MG TAB (EMC) MYCOPHENOLATE 60'S BQ 1.033 500MG 180 2024-04-01 2026-03-31 0
40 A0421 CELLCEPT 250MG CAP (ROC/AHI) MYCOPHENOLATE 100'S BQ 1.90 250MG 0 2022-04-01 2024-03-31 6
41 A0421 CELLCEPT 250MG CAP (ROC) MYCOPHENOL (C) 100'S C 1.9028 250MG 360 2024-04-01 2026-03-31 6
42 A0421 CELLCEPT 250MG CAP (ROC) MYCOPHENOL 100'S BQ 1.90 250MG 360 2026-04-01 No No 0
40 A0422 MYFORTIC 180MG CAP (NVS/COL) MYCOPHENOLIC ACI 120'S C 2.67 180MG 0 2022-04-01 2024-03-31 0
41 A0422 MYFORTIC 180MG CAP (NVS) MYCOPHENOLIC AC (C) 120'S C 2.673 180MG 240 2024-04-01 2026-03-31 6
41 A042G APO-MYCOPHENOLATE 250MG CAP (APO) (BQ) 100'S BQ 0.5102 250MG 360 2024-04-01 2026-03-31 6