Displaying 1 - 5 of 5
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 19633 CALCIUM GLUCONATE 10% INJ (BRA/COL) 20X10ML B 1.56 10% 0 2022-04-01 2024-03-31 0
41 19633 CALCIUM GLUCONATE 10% INJ (BRA) (B) 20X10ML B 0.6714 10% 10 2024-04-01 2026-03-31 0
42 19633 CALCIUM GLUCONATE 10% INJ (BRA) 20X10ML B 1.63 10% 10 2026-04-01 No No 0
42 1963V INJECAL 10% INJ (FSB) CALCIUM GLUCONATE 20X10ML B 0.64 10% 10 2026-04-01 No No Package Size Change 0
42 1963W INJECAL 10% INJ (FSB) CALCIUM GLUCONATE 2X5X10ML B 6.39 10% 10 2026-04-01 No No Add to Contract as Cat B 0