Displaying 1721 - 1740 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 | 2511AY | KONSYL DAILY PSYLLIUM FIBER PWDR (C) | 360 | C | 55.05 | 55.05 | 0000-00-00 | 0000-00-00 | CONTRACT AWARDED CAT C | |||||
| 40 | 2511AZ | KONSYL DAILY ORANGE SF PWDR (KSY) (C) | 324'S | C | $44.85 | 0000-00-00 | 0000-00-00 | CONTRACT AWARDED CAT C | ||||||
| 40 | 2551C | FLEET ENEMA ADULT 7G | 19G (FLE/AHI) SODIUM BIPHOSPHATE | SODIUM PHOSPHATE | 133ML | A | 2.23 | 7G|19G | 2 | 2022-04-01 | 2024-03-31 | 6 | ||||
| 41 | 2551C | FLEET ENEMA ADULT 7G|19G ENEMA (FLE) SODIUM BIPHOSPHATE|SODI | 133ML | A | 2.9358 | 7G|19G | 2 | 2024-04-01 | 2026-03-31 | 6 | ||||
| 41 | 2551E | QC ENEMA ADULT 7G|19G ENEMA (QUC) SODIUM BIPHOSPHATE|SODIUM | 133ML | A | 3.561 | 7G|19G | 2 | 2024-04-01 | 2026-03-31 | 6 | ||||
| 42 | 2551E | QC ENEMA ADULT 7G|19G ENEMA (QUC) SODIUM BIPHOSPHATE|SODIUM | 133ML | A | 3.56 | 7G|19G | 2 | 2026-04-01 | No | No | 6 | |||
| 40 | 2551F | ENEMA-LAX ADULT 7G | 19G ENEMA (LAF/AHI) SODIUM BIPHOSPHATE | SODIUM PHOSPHATE | 133ML | A | 3.89 | 7G|19G | 2 | 2022-04-01 | 2024-03-31 | Change Local Agent | 6 | |||
| 42 | 2551F | ENEMA-LAX ADULT 7G|19G ENEMA (LAF) SODIUM BIPHOSPHATE|SODIUM | 133ML | B | 8.83 | 7G|19G | 2 | 2026-04-01 | No | No | 6 | |||
| 40 | 25527 | FLEET ENEMA PAED 3.5G | 9.5G (FLE/AHI) SODIUM | 66ML | B | 5.79 | 9.5G|3.5G | 0 | 2022-04-01 | 2024-03-31 | 0 | ||||
| 41 | 25527 | FLEET ENEMA PAED 3.5G|9.5G (FLE) SODIUM | 66ML | A | 3.262 | 9.5G|3.5G | 2 | 2024-04-01 | 2026-03-31 | 6 | ||||
| 40 | 25528 | ENEMA-LAX CHILD 9.5G | 3.5G ENEMA (LAF/AHI) SODIUM BIPHOSPHATE | SODIUM PHOSPHAT More ... | 66ML | A | 3.89 | 9.5G|3.5G | 2 | 2022-04-01 | 2024-03-31 | Change Local Agent | 6 | |||
| 42 | 25528 | ENEMA-LAX CHILD 9.5G|3.5G ENEMA (LAF) SODIUM BIPHOSPHATE|SOD | 66ML | A | 8.15 | 9.5G|3.5G | 2 | 2026-04-01 | No | No | 6 | |||
| 40 | 25611 | GRAVOL 50MG TAB (CDC/COL) DIMENHYDRINAT | 100'S | C | 0.25 | 50MG | 0 | 2022-04-01 | 2024-03-31 | 0 | ||||
| 41 | 25611 | GRAVOL 50MG TAB (CDC) DIMENHYDRINAT (C) | 100'S | C | 0.2754 | 50MG | 180 | 2024-04-01 | 2026-03-31 | 6 | ||||
| 42 | 25611 | GRAVOL 50MG TAB (CDC) DIMENHYDRINAT | 100'S | C | 0.29 | 50MG | 180 | 2026-04-01 | No | No | 6 | |||
| 40 | 25619 | GRAVOL 50MG TAB (CDC/COL) DIMENHYDRINATE | 30'S | C | 0.24 | 50MG | 0 | 2022-04-01 | 2024-03-31 | 0 | ||||
| 41 | 25619 | GRAVOL 50MG TAB (CDC) DIMENHYDRINAT (C) | 30'S | C | 0.251 | 50MG | 180 | 2024-04-01 | 2026-03-31 | 6 | ||||
| 40 | 2561B | GRAVOL 50MG TAB (CDC/COL) DIMENHYDRINATE | 10'S | C | 0.34 | 50MG | 0 | 2022-04-01 | 2024-03-31 | 0 | ||||
| 41 | 2561B | GRAVOL 50MG TAB (CDC) DIMENHYDRINAT (C) | 10'S | C | 0.3724 | 50MG | 180 | 2024-04-01 | 2026-03-31 | 6 | ||||
| 42 | 2561B | GRAVOL 50MG TAB (CDC) DIMENHYDRINAT | 10'S | C | 0.41 | 50MG | 180 | 2026-04-01 | No | No | 6 | |||