Displaying 1681 - 1700 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 2372X XYLOMETAZOLINE 0.1% NASAL SP (FSB) 10ML A 2.42 0.1% 1 2026-04-01 No No Add to Contract as Cat A 0
40 23739 OTRIVINE 0.05% NASAL DR (GSK/COL) XYLOMETAZOL 10ML A 4.70 0.05% 1 2022-04-01 2024-03-31 0
41 23739 OTRIVINE 0.05% NASAL DR (GSK) XYLOMETAZO (C) 10ML C 4.9473 0.05% 1 2024-04-01 2026-03-31 0
42 23739 OTRIVINE 0.05% NASAL DR (GSK) XYLOMETAZO 10ML A 5.19 0.05% 1 2026-04-01 No No 0
41 2373E XYLOMETAZOLINE 0.05% NASAL DR (KWA) 15ML A 2.6096 0.05% 1 2024-04-01 2026-03-31 0
40 2373G OXOZOLIN PAED 0.025% NASAL DR (ARP/AHI) OXYME 10ML A 4.05 0.025% 1 2022-04-01 2024-03-31 0
40 2373S XYLOMETAZOLINE 0.05% NASAL DR (CIR/AHI) 10ML A 2.31 0.05% 1 2022-04-01 2022-09-30 6
40 2392B PMS-RISEDRONATE 35MG TAB (PMS/COL) 4'S C 3.74 35MG 0 2022-04-01 2024-03-31 0
42 2392B PMS-RISEDRONATE 35MG TAB (PMS) 4'S C 2.38 35MG 0 2026-04-01 No No 0
41 2392C APO-RISEDRONATE 35MG TAB (APO) (C) 4'S C 2.4261 35MG 0 2024-04-01 2026-03-31 0
40 2401A IDEW-FLO 1MG STRP (ENT/PHA) FLUORESCEIN 100'S B 20.12 1MG 0 2022-04-01 2024-03-31 0
41 2401A IDEW-FLO 1MG STRP (ENT) FLUORESCEIN 100'S B 0.227 1MG 0 2024-04-01 2026-03-31 0
42 2401AA I-DEW FLO 1MG STRP (ENT) FLUORESCEIN 100'S B 0.20 1MG 0 2026-04-01 No No 0
40 24041 FLUORESCEIN MINIMS 1% EYE/EAR DR (CAM/STO) 20X0.5ML B 4.74 1% 0 2022-04-01 2024-03-31 0
41 24042 FLUORESCEIN MINIMS 1% EYE DR (CAM) (B) 20X0.5ML B 4.1264 1% 0 2024-04-01 2026-03-31 0
40 2411B HYPROMELLOSE 0.3% EYE DR (ASL/PHA) 10ML A 3.75 0.3% 1 2022-04-01 2024-03-31 6
41 2411B HYPROMELLOSE 0.3% EYE DR (ASL) 10ML A 7.6385 0.3% 1 2024-04-01 2026-03-31 6
42 2411J LACRYL SOOTHE 0.3% EYE DR (ABL) HYPROMELLOSE 10ML A 3.94 0.3% 1 2026-04-01 No No 6
40 2451AF LOPERAMIDE 2MG CAP (CIP/AHI) 30X10 A 0.09 2MG 30 2022-04-01 2024-03-31 6
40 2451AN ALKA AD 2MG TAB (BSP/COL) LOPERAMIDE 60'S C 0.29 2MG 0 2022-04-01 2024-03-31 0