Displaying 1761 - 1780 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 25643 GRAVOL INFANT 25MG SUPPOS (CDC) DIMENHYD 10'S A 1.0384 25MG 10 2024-04-01 2024-12-03 0
41 25643 GRAVOL INFANT 25MG SUPPOS (CDC) DIMENHYD 10'S A 1.38 25MG 10 2024-12-04 2026-03-31 0
42 25643 GRAVOL INFANT 25MG SUPPOS (CDC) DIMENHYD 10'S A 1.56 25MG 10 2026-04-01 No No 0
41 2565AA LADRINATE 50MG/ML IV/IM INJ (LDP) DIMENHYDRINATE (B) 5X5ML B 3.9144 50MG/ML IV/IM 60 2024-04-01 2026-03-31 6
40 2565G DIMENHYDRINATE 50MG/ML IV/IM INJ (RTM/PHA) 5ML VIAL C 4.84 50MG/ML IV/IM 0 2022-04-01 2024-03-31 0
41 2565G DIMENHYDRINATE 50MG/ML IV/IM INJ (RTM) (C) 5ML VIAL C 4.9473 50MG/ML IV/IM 60 2024-04-01 2026-03-31 6
42 2565H DIMENHYDRINATE 50MG/ML IM INJ (RTM) 25X5ML C 3.26 50MG/ML IM 60 2026-04-01 No No 6
41 2565S DIMENHYDRINATE 50MG/ML IV/IM INJ (FSB) (B) 5ML B 2.3649 50MG/ML IV/IM 60 2024-04-01 2026-03-31 6
40 2565T DIMENHYDRINATE 50MG/ML IV/IM INJ (MON/PHA) 5ML B 2.20 50MG/ML IV/IM 0 2022-04-01 2024-03-31 0
40 2565Y DIMENHYDRINATE 50MG/ML INJ (LAF/AHI) 100X1ML B 50MG/ML 0 2022-04-01 2024-03-31 Change Local Agent 0
42 2565Y DIMENHYDRINATE 50MG/ML IV/IM INJ (LAF) 100X1ML B 1.14 50MG/ML IV/IM 60 2026-04-01 No No 6
40 25671 GRAVOL DUAL RELIEF 100MG CAP (CDC/COL) DIMENH 24'S C 0.52 100MG 0 2022-04-01 2024-03-31 0
41 25671 GRAVOL DUAL RELIEF 100MG CAP (CDC) DIMEN (C) 24'S C 0.6479 100MG 0 2024-04-01 2026-03-31 0
42 25671 GRAVOL DUAL RELIEF 100MG CAP (CDC) DIMEN 24'S C 0.61 100MG 0 2026-04-01 No No 0
40 25672 GRAVOL DUAL RELIEF 100MG CAP (CDC/COL) DIMENH 8'S C 0.63 100MG 0 2022-04-01 2024-03-31 0
41 25672 GRAVOL DUAL RELIEF 100MG CAP (CDC) DIMEN (C) 8'S C 0.649 100MG 0 2024-04-01 2026-03-31 0
42 25672 GRAVOL DUAL RELIEF 100MG CAP (CDC) DIMEN 8'S C 0.74 100MG 0 2026-04-01 No No 0
40 25713 BETHASONE 0.1% OINT (GPC/ATB) BETAMETHASONE 15G A 1.41 0.1% 2 2022-04-01 2024-03-31 0
40 25718 BETACORT 0.1% OINT (CAR/COL) BETAMETHASONE 15G C 4.62 1MG/G 0 2022-04-01 2024-03-31 0
41 25718 BETACORT 0.1% OINT (CAR) BETAMETHASONE 15G A 4.6212 1MG/G 2 2024-04-01 2026-03-31 0