Displaying 921 - 940 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 12345 AAP-ISOSORBIDE DINITRATE 30MG TAB (APO) 100'S A 0.08 30MG 90 2026-04-01 No No 6
42 12413 APO-RALOXIFENE 60MG TAB (APO) 100'S C 0.97 60MG 0 2026-04-01 No No 0
40 1241E RALOXIFENE 60MG TAB (DRL/AHI) 30'S C 1.33 60MG 0 2022-04-01 2024-03-31 0
41 1241F APO-RALOXIFENE 60MG TAB (APO) 100'S C 0.9704 60MG 0 2024-04-01 2026-03-31 0
41 1261F SEVOFLURANE SOLN (BAX) (BQ) 250ML BQ 197.8668 100% 30 2024-04-01 2026-03-31 0
40 1261L ULTANE (4456-02) (ABB/PHA) SEVOFLURANE 250ML BQ 265.04 100% 0 2022-04-01 2024-03-31 0
41 1261L ULTANE (4456-02) (ABB) SEVOFLURANE (BQ) 250ML BQ 264.7376 100% 30 2024-04-01 2026-03-31 0
42 1261L ULTANE (4456-02) BOTTLE (ABB) SEVO 250ML BQ 244.65 100% 30 2026-04-01 No No 0
40 1261P AERRANE (BAX/STO) ISOFLURANE 250ML C 66.54 99.9% 0 2022-04-01 2024-03-31 0
41 1261P AERRANE (BAX) ISOFLURANE (C) 250ML C 58.6886 99.9% 0 2024-04-01 2026-03-31 0
42 1261P AERRANE (BAX) ISOFLURANE 250ML C 77.85 99.9% 0 2026-04-01 No No 0
40 1261Q SUPRANE (10019-641-24) (BAX/STO) DESFLURANE 240ML BQ 231.06 100% 0 2022-04-01 2024-03-31 0
41 1261Q SUPRANE (10019-641-24) (BAX) DESFLURANE (BQ) 240ML BQ 232.8788 100% 200 2024-04-01 2026-03-31 0
42 1261Q SUPRANE (10019-641-24) (BAX) DESFLURANE 240ML BQ 312.61 100% 200 2026-04-01 No No 0
40 1261S AERRANE SOLN (BAX/STO) ISOFLURANE 100ML C 34.06 99.9% 0 2022-04-01 2024-03-31 0
41 1261S AERRANE SOLN (BAX) ISOFLURANE (C) 100ML C 38.6546 99.9% 0 2024-04-01 2026-03-31 0
42 12718 KETAMINE 50MG/ML INJ (RTM) 25X10ML BQ 5.16 50MG/ML 0 2026-04-01 No No 0
40 1271A KETAMINE 50MG/ML INJ (RTM/PHA) 10ML VIAL BQ 7.26 50MG/ML 0 2022-04-01 2022-05-31 0
40 1271A KETAMINE 50MG/ML INJ (RTM/PHA) 10ML VIAL BQ 11.34 50MG/ML 0 2022-06-01 2024-03-31 Price Change 0
41 1271A KETAMINE 50MG/ML INJ (RTM) (BQ) 10ML VIAL BQ 11.4441 50MG/ML 0 2024-04-01 2025-01-28 0