Displaying 4921 - 4940 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 A061C FLUDARABINE 50MG INJ (INP/AHI) 50MG VIAL BQ 134.61 50MG 0 2022-04-01 2024-03-31 0
42 A061F FLUDARABINE 50MG INJ (KWA) 50MG VIAL BQ 626.93 50MG 0 2026-04-01 No No Add to Contract 0
40 A0811 PNEUMOVAX 23 INJ (MSD/STO) PNEUMOCOCCAL 0.5ML VIAL C 23.98 25MCG 0 2022-07-26 2024-03-31 Package Size Change
41 A0811 PNEUMOVAX 23 INJ (MSD) PNEUMOCOCCAL 0.5ML VIAL B 24.6824 25MCG 1 2024-04-01 2026-03-31 0
40 A0814 PNEUMOVAX 23 25MCG INJ (MSD/STO) PNEUMOCOCCAL 10X0.5ML B 23.98 25MCG 0 2022-04-01 2024-03-31 0
40 A0825 PREVNAR 13 16MCG INJ (PFI/STO) PNEUMOCOCCAL 1 DOSE B 176.23 16MCG 0 2022-04-01 2022-06-21 0
40 A0825 PREVNAR 13 16MCG INJ (PFI/STO) PNEUMOCOCCAL 1 DOSE B 223.12 16MCG 0 2022-06-22 2024-03-31 Price Change 0
41 A0825 PREVNAR 13 16MCG INJ (PFI) PNEUMOCOCCAL 1 DOSE B 177.9415 16MCG 1 2024-04-01 2026-03-31 0
42 A0825 PREVNAR 13 16MCG INJ (PFI) STREPTOCOCCUS PNEUMONIA TYPES 0.5ML PFS B 177.94 16MCG 0 2026-04-01 No No 0
40 A101L LABETALOL 5MG/ML INJ (MON/PHA) 20ML B 8.67 5MG/ML 0 2022-04-01 2024-03-31 0
42 A101L LABETALOL 5MG/ML INJ (MON) 20ML B 4.65 5MG/ML 0 2026-04-01 No No 0
40 A101M LABETALOL 5MG/ML INJ (KWA/ATB) 20ML AMP B 4.05 5MG/ML 0 2022-04-01 2024-03-31 0
41 A101T LABETALOL 5MG/ML INJ (LDP) (B) 20ML B 7.0948 5MG/ML 0 2024-04-01 2026-03-31 0
41 A101U LABETALOL 5MG/ML INJ (FSB) (B) 20ML VIAL B 4.9473 5MG/ML 0 2024-04-01 2026-03-31 0
42 A101X LABETALOL 5MG/ML INJ (FSB) 20ML VIAL B 4.43 5MG/ML 0 2026-04-01 No No Add to Contract as Cat B 0
40 A1022 APO-LABETALOL 100MG TAB (APO/COL) 100'S A 0.54 100MG 90 2022-04-01 2024-03-31 6
42 A1022 APO-LABETALOL 100MG TAB (APO) 100'S A 0.55 100MG 90 2026-04-01 No No 6
40 A102D LABETALOL 100MG TAB (LDP/AHI) 100'S A 0.68 100MG 90 2022-04-01 2022-09-30 6
41 A102F APO-LABETALOL 100MG TAB (APO) 100'S A 0.5545 100MG 90 2024-04-01 2026-03-31 6
42 A102L LIBETOR 100MG TAB (JLP) LABETALOL 10X10 A 0.24 100MG 90 2026-04-01 No No 6