Displaying 101 - 120 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 0072K APO-ZOLPIDEM 10MG TAB (APO/COL) 30'S C 0.67 10MG 0 2022-04-01 2024-03-31 0
42 0072K APO-ZOLPIDEM 10MG TAB (APO) ZOLPIDE 30'S C 0.68 10MG 0 2026-04-01 No No 0
42 0072L PMS-ZOLPIDEM 10MG OD TAB (PMS) 3X10 C 0.82 10MG 0 2026-04-01 No No 0
42 0081AB AMBISONE LIPOSOMAL 50MG INJ (GIL) A 50MG VIAL BQ 581.72 50MG 21 2026-04-01 No No 0
40 0081AG AMPHOTIN 50MG INJ (UBI/RXP) AMPHOTERICIN B 50MG VIAL BQ 19.71 50MG 0 2022-04-01 2024-03-31 0
40 0081AJ AMPHIZOME 50MG INJ (FSB/ATB) AMPHOTERICIN B 5ML BQ 24.46 50MG 0 2022-04-01 2024-03-31 0
42 0081AK AMPHIZOME 50MG INJ (FSB) AMPHOTERICIN B 5ML BQ 12.53 50MG 21 2026-04-01 No No Add to Contract 0
40 0081T FLUCONAZOLE 200MG INJ (BRA/COL) 100ML BQ 4.65 200MG 0 2022-04-01 2024-03-31 0
41 0081T FLUCONAZOLE 200MG INJ (BRA) (BQ) 100ML BQ 4.9202 200MG 0 2024-04-01 2026-03-31 0
42 0081T FLUCONAZOLE 200MG INJ (BRA) 100ML BQ 6.31 200MG 0 2026-04-01 No No 0
40 00915 GRISEOFULVIN 125MG TAB (REM/SBI) 10x10 A 0.17 125MG 60 2022-04-01 2024-03-31 6
41 00915 GRISEOFULVIN 125MG TAB (REM) 10x10 A 0.1408 125MG 60 2024-04-01 2026-03-31 6
42 00915 GRISEOFULVIN 125MG TAB (REM) 10x10 A 0.14 125MG 60 2026-04-01 No No 6
40 00923 GRISEOFULVIN 500MG TAB (REM/SBI) 10X10 A 0.28 500MG 60 2022-04-01 2024-03-31 6
41 00923 GRISEOFULVIN 500MG TAB (REM) 10X10 A 0.2743 500MG 60 2024-04-01 2026-03-31 6
42 00923 GRISEOFULVIN 500MG TAB (REM) 10X10 A 0.28 500MG 60 2026-04-01 No No 6
40 00939 GRISEOFULVIN 25MG/ML SUSP (SUE/AHI) 120ML A 0.12 25MG/ML 500 2022-04-01 2024-03-31 6
41 00939 GRISEOFULVIN 25MG/ML SUSP (SUE) 120ML A 0.1309 25MG/ML 500 2024-04-01 2026-03-31 6
40 0093A FLUVIN 25MG/ML SUSP (RYV/ALW) GRISEOFULVIN 100ML A 0.12 25MG/ML 500 2022-04-01 2024-03-31 6
40 01027 NYSTATIN 100,000U/ML SUSP (HEA/RXP) 60ML A 0.10 100,000U/ML 180 2022-04-01 2024-03-31 0