Displaying 1481 - 1500 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 2012V POTASSIUM CHLORIDE 2MEQ/ML INJ (MON 5X10ML B 1.50 2MEQ/ML 0 2026-04-01 No No 0
41 2012X POTASSIUM CHLORIDE 2MEQ/ML INJ (FSB) (B) 5X10ML B 1.142 2MEQ/ML 0 2024-04-01 2026-03-31 0
42 20313 K BIND 15G PWDR (SLS) CALCIUM POLYSTYRENE SULPHONATE 20'S BQ 9.07 15G 20 2026-04-01 No No 0
40 20317 CALCIUM POLYSTYRENE SULPHONATE PWDR (SLS/AHI 300G A 159.76 15G 1 2022-04-01 2024-03-31 6
40 20413 AMINOPLASMAL E 10% SOLN (BRA/COL) AMINO ACID 500ML BQ 15.20 10% 0 2022-04-01 2024-03-31 0
41 20413 AMINOPLASMAL E 10% (BRA) AMINO ACID (BQ) 500ML BQ 16.4459 10% 100 2024-04-01 2026-03-31 0
42 20413 AMINOPLASMAL E 10% (BRA) AMINO ACID 500ML BQ 24.46 10% 100 2026-04-01 2028-03-31 No No 0
40 20425 AMINOPLASMAL E 5% SOLN (BRA/COL) AMINO ACID 500ML BQ 13.75 5% 0 2022-04-01 2024-03-31 0
41 20425 AMINOPLASMAL E 5% (BRA) AMINO ACID (BQ) 500ML BQ 14.3528 5% 100 2024-04-01 2026-03-31 0
42 20425 AMINOPLASMAL E 5% (BRA) AMINO ACID 500ML BQ 19.57 5% 100 2026-04-01 2028-03-31 No No 0
40 20443 AMINOPLASMAL W | O ELECTROLYTES 15% INJ (BRA/COL) AMINO ACID 500ML BQ 26.45 15% 0 2022-04-01 2024-03-31 0
41 20443 AMINOPLASMAL W|O ELECTROLYTES 15% INJ (BRA) AMINO ACID (BQ) 500ML BQ 28.189 15% 100 2024-04-01 2026-03-31 0
42 20443 AMINOPLASMAL W|O ELECTROLYTES 15% INJ (BRA) AMINO ACID 500ML BQ 48.93 15% 100 2026-04-01 No No 0
40 20515 DEXTROSE 50% INJ (BRA/COL) 50ML B 1.88 50% 0 2022-04-01 2024-03-31 0
41 20515 DEXTROSE 50% INJ (BRA) 50ML B 2.2834 50% 59 2024-04-01 2026-03-31 0
42 20515 DEXTROSE 50% INJ (BRA) 50ML B 3.75 50% 59 2026-04-01 No No 0
40 20523 DEXTROSE 5% INJ (CSC/PHA) 250ML B 2.65 5% 0 2022-04-01 2022-06-15 Price Change 0
40 20523 DEXTROSE 5% INJ (CSC/PHA) 250ML B 3.02 5% 0 2022-06-16 2024-03-31 Price Change 0
41 20523 DEXTROSE 5% INJ (CSC) (B) 250ML B 2.1203 5% 100 2024-04-01 2026-03-31 0
40 2052F DEXTROSE (2B0062Q) 5% INJ (BAX/STO) 250ML B 3.32 5% 0 2022-04-01 2024-03-31 0