Displaying 5261 - 5280 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 A531AH LOUTEN EMULSION 0.005% EYE DR (LPO) LATA 2.5ML C 16.31 0.005% 1 2026-04-01 No No 6
41 A531AW BIMATOPROST 0.01% EYE DR (CIR) 2.5ML A 9.24 0.01% 1 2024-07-23 2025-01-16 6
41 A531AW BIMATOPROST 0.01% EYE DR (CIR) 2.5ML A 12.83 0.01% 1 2025-01-17 2026-03-31 Yes 6
40 A531AZ TRAVATAN BAK 0.004% EYE DR (NVS/COL) TRAVOPROST 2.5ML A 10.87 0.004% 1 2022-04-01 2024-03-31 6
41 A531AZ TRAVATAN BAK 0.004% EYE DR (NVS) TRAVOPROST 2.5ML A 10.8733 0.004% 1 2024-04-01 2026-03-31 Yes 6
42 A531AZ TRAVATAN BAK 0.004% EYE DR (NVS) TRAVOPROST 2.5ML A 10.82 0.004% 1 2026-04-01 No No 6
41 A531BF XALATAN 0.005% EYE DR (PFI) LATANOPROST 2.5ML A 8.8617 0.005% 2 2024-04-01 2026-03-31 Yes 6
42 A531BF XALATAN 0.005% EYE DR (PFI) LATANOPROST 2.5ML A 8.51 0.005% 1 2026-04-01 No No 6
42 A531BH BITOD LS 0.01% EYE DR (SYP) BIMATOPROST 3ML A 8.54 0.01% 1 2026-04-01 No No 6
40 A531H XALATAN 0.005% EYE DR (PFI/SBI) LATANOPROST 2.5ML A 11.66 0.005% 1 2022-04-01 2024-03-31 Price Change 6
41 A531H XALATAN 0.005% EYE DR (PFI) LATANOPROST 2.5ML A 8.8617 0.005% 1 2024-04-01 2026-03-31 Yes 6
40 A531J LUMIGAN 0.01% EYE DR (ALL/COL) BIMATOPROST 2.5ML C 41.32 0.01% 0 2022-04-01 2024-03-31 0
41 A531J LUMIGAN 0.01% EYE DR (ALL) BIMATOPROST (C) 2.5ML C 41.3185 0.01% 1 2024-04-01 2026-03-31 Yes 6
42 A531J LUMIGAN 0.01% EYE DR (ALL) BIMATOPROST 2.5ML C 41.32 0.01% 1 2026-04-01 No No 6
40 A531W SAFLUTAN 0.015MG/ML EYE DR (MSD/STO) TAFLUPROST 30X0.3ML B 36.43 0.015MG/ML 0 2022-04-01 2024-03-31 6
41 A573H ALENDRONATE 70MG TAB (CIP) (B) 40'S B 0.5484 70MG 5 2024-04-01 2026-03-31 6
42 A573K ALENDRONATE 70MG TAB (CIP) 4'S BQ 0.95 70MG 5 2026-04-01 No No 0
40 A573P ALENDRONATE 70MG TAB (APL/AHI) 4'S B 0.91 70MG 0 2022-04-01 2024-03-31 6
40 A5916 DOXORUBICIN 50MG SOLN FOR INJ (EBA/COL) 50MG VIAL BQ 34.93 50MG 0 2022-04-01 2024-03-31 Price Change 0
40 A591AA DOXORUBICIN 50MG SOLN FOR INJ (DIL/AHI) 50MG VIAL BQ 25.91 50MG 0 2022-04-01 2024-03-31 0