Displaying 1641 - 1660 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
41 2331J PILOCARPINE 2% EYE DR (MTP) 10ML A 13.0751 2% 1 2024-04-01 2026-03-31 6
42 23325 PILOCARPINE EYE DR (MTP) 10ML C 41.86 4% 1 2026-04-01 No No 6
40 2332H PILOCARPINE 4% EYE DR (MTP/COL) 10ML C 16.74 4% 0 2022-04-01 2024-03-31 Price Change 0
41 2332H PILOCARPINE 4% EYE DR (MTP) (C) 10ML C 14.4887 4% 1 2024-04-01 2025-01-28 6
41 2332H PILOCARPINE 4% EYE DR (MTP) (C) 10ML C 21.56 4% 1 2024-04-11 2026-03-31 6
40 23361 PILOCARPINE MINIMS 2% EYE DR (CAM/STO) 20X0.5ML B 4.74 2% 0 2022-04-01 2024-03-31 6
41 23362 PILOCARPINE MINIMS 2% EYE DR (CAM) (B) 20X0.5ML B 4.8305 2% 0 2024-04-01 2026-03-31 0
40 23414 MATROPIN 2% EYE DR (ARP/AHI) HOMATROPINE 10ML A 14.11 2% 1 2022-04-01 2024-03-31 0
41 23415 HOMACID 2% EYE DR (SHC) HOMATROPINE 5ML A 1.2232 2% 1 2024-04-01 2026-03-31 0
42 23415 HOMACID 2% EYE DR (SHC) HOMATROPINE 5ML B 2.07 2% 1 2026-04-01 No No 0
40 23516 PHENYLEPHRINE MINIMS 10% EYE DR (CAM/STO) 20X0.5ML B 4.74 10% 0 2022-04-01 2024-03-31 6
41 23518 PHENYLEPHRINE MINIMS 10% EYE DR (CAM) (BQ) 20X0.5ML BQ 4.1264 10% 0 2024-04-01 2026-03-31 0
40 23539 PHENYLEPHRINE 10MG/ML INJ (SLS/AHI) 1ML AMP B 22.07 10MG/ML 0 2022-04-01 2022-09-30 0
40 2353D PHRINTEC 10MG/ML IV/IM INJ (UBI/RXP) PHENYLEP 1ML VIAL B 10.60 10MG/ML IV/IM 0 2022-04-01 2024-03-31 0
41 2353F PHENYLEPHRINE 10MG/ML INJ (OMG) (BQ) 10X1ML BQ 6.6327 10MG/ML 0 2024-04-01 2026-03-31 0
42 2353G PHENYLEPHRINE 10MG/ML INJ (MTP) 10X1ML B 11.47 10MG/ML 0 2026-04-01 No No 0
40 23541 PHENYLEPHRINE MINIMS 2.5% EYE DR (CAM/STO) 20X0.5ML B 4.74 2.5% 0 2022-04-01 2024-03-31 6
41 23548 PHENYLEPHRINE MINIMS 2.5% EYE DR (CAM) (BQ) 20X0.5ML BQ 4.1264 2.5% 0 2024-04-01 2026-03-31 0
41 23611 TROPICAMIDE MINIMS 1% EYE DR (CAM) (B) 20X0.5ML B 4.1264 1% 20 2024-04-01 2026-03-31 0
40 23613 TROPICAMIDE MINIMS 1% EYE DR (CAM/STO) 20X0.5ML B 4.74 1% 0 2022-04-01 2024-03-31 6