Displaying 1 - 20 of 29
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 0131AE AZITHROMYCIN MK 40MG/ML SUSP (BON/COL) 15ML A 0.35 40MG/ML 30 2022-04-01 2024-03-31 0
42 0131B AZITHRO EZE 40MG/ML SUSP (INF) AZITHROMYCIN 15ML A 0.31 40MG/ML 30 2026-04-01 No No 0
40 0131BE SKAZI 40MG/ML SUSP (SKH/RXP) AZITHROMYCIN 15ML A 0.33 40MG/ML 30 2022-04-01 2024-03-31 0
40 0131CW AZITHROMYCIN 40MG/ML SUSP (KWA/ATB) 15ML A 0.32 40MG/ML 30 2022-04-01 2022-09-30 0
40 0131CX BINOZYT 40MG/ML SUSP (BCH/COL) AZITHROMYCIN 30ML C 0.67 40MG/ML 0 2022-04-01 2024-03-31 0
41 0131CX BINOZYT 40MG/ML SUSP (BCH) AZITHROM (C) 30ML C 0.9704 40MG/ML 30 2024-04-01 2026-03-31 0
42 0131CX BINOZYT 40MG/ML SUSP (BCH) AZITHROM 30ML C 0.97 40MG/ML 30 2026-04-01 No No 0
40 0131DT SKAZI 40MG/ML SUSP (SKH) 15ML A 40MG/ML 30 0
41 0131DT SKAZI 40MG/ML SUSP (SKH) AZITHROMYCIN 15ML A 0.3298 40MG/ML 30 2024-06-05 2026-03-31 0
40 0131U ZITHROMAX 40MG/ML SUSP (PFI/STO) AZITHROMYCIN 15ML C 1.98 40MG/ML 0 2022-04-01 2024-03-31 0
41 0131U ZITHROMAX 40MG/ML SUSP (PFI) AZITHRO (C) 15ML C 1.9971 40MG/ML 30 2024-04-01 2026-03-31 0
42 0131U ZITHROMAX 40MG/ML SUSP (PFI) AZITHR 15ML C 2.00 40MG/ML 30 2026-04-01 No No 0
40 0141AH ZITHROMAX 500MG TAB (PFI/STO) AZITHROMYCIN 3'S C 17.67 500MG 0 2022-04-01 2024-03-31 0
41 0141AH ZITHROMAX 500MG TAB (PFI) AZITHROMY (C) 3'S C 17.8413 500MG 7 2024-04-01 2026-03-31 0
42 0141AH ZITHROMAX 500MG TAB (PFI) AZITHROMY 3'S C 17.84 500MG 10 2026-04-01 No No 0
40 0141DA BINOZYT 500MG TAB (BCH/COL) AZITHROMYCIN 3'S C 2.88 500MG 0 2022-04-01 2024-03-31 0
41 0141DA BINOZYT 500MG TAB (BCH) AZITHROMYCIN (C) 3'S C 8.164 500MG 7 2024-04-01 2026-03-31 0
42 0141DA BINOZYT 500MG TAB (BCH) AZITHROMYCIN 3'S C 9.28 500MG 10 2026-04-01 No No 0
40 0141GA BINOZYT 500MG TAB (BCH/COL) AZITHROMYCIN 12'S C 2.62 500MG 0 2022-04-01 2024-03-31 0
40 0141GB EZECURE 500MG TAB (EMC/COL) AZITHROMYCIN 3'S A 0.46 500MG 7 2022-04-01 2024-03-31 0