Displaying 1 - 9 of 9
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 30016 BUPIVACAINE 0.25% INJ (KWA/ATB) 10ML BQ 6.12 0.25% 0 2022-04-01 2024-03-31 0
41 30016 BUPIVACAINE 0.25% INJ (KWA) 10ML BQ 5.3551 0.25% 2 2024-04-01 2026-03-31 0
40 3002X LABUPI 0.25% INJ (LDP/AHI) BUPIVACAINE 20ML BQ 15.22 0.25% 0 2022-04-01 2024-03-31 0
40 3002Y BUPIVACAINE 0.25% INJ (KWA/ATB) 20ML BQ 8.56 0.25% 0 2022-04-01 2024-03-31 Add to Contract as Cat B 0
41 3002Y BUPIVACAINE 0.25% INJ (KWA) 20ML BQ 15.9566 0.25% 2 2024-04-01 2026-03-31 0
40 3003G BUPIVACINE SPINAL HEAVY 0.5% INJ (BAX/STO) BU 5X4ML BQ 4.02 0.5% 0 2022-04-01 2024-03-31 0
41 3003L BUPIVACAINE HEAVY 0.5% INJ (FSB) (BQ) 5X4ML BQ 1.9681 0.5% 2 2024-04-01 2026-03-31 0
40 3004F LABUPI 0.5% INJ (LDP/AHI) BUPIVACAINE 10ML BQ 6.36 0.5% 0 2022-04-01 2024-03-31 0
41 3004H BUPIVACAINE 0.5% INJ (FSB) 20ML BQ 7.5298 0.5% 2 2024-04-01 2026-03-31 0