Displaying 1 - 7 of 7
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 02223 CLOXACILLIN 500MG CAP (REM/SBI) 10x10 A 0.16 500MG 28 2022-04-01 2024-03-31 0
41 02238 CLOXACILLIN 25MG/ML SUSP (KWA) 60ML A 0.4304 25MG/ML 300 2024-04-01 2026-03-31 0
40 0225H LACLOXA 500MG INJ (LDP/AHI) CLOXACILLIN 500MG VIAL B 15.41 500MG 0 2022-04-01 2022-09-30 6
40 0225K CLOXACILLIN 500MG INJ (MON/PHA) 500MG VIAL B 1.58 500MG 0 2022-04-01 2024-03-31 6
41 0225L CLOXACILLIN 500MG INJ (JOL) (B) 500MG VIAL B 6.3065 500MG 56 2024-04-01 2026-03-31 6
41 0225M LACLOXA 500MG INJ (LDP) CLOXACILLIN (B) 10X5ML B 6.2793 500MG 56 2024-04-01 2026-03-31 6
42 0225N CLOXAMAX 500MG INJ (JLP) CLOXACILLIN 500MG VIAL BQ 5.98 500MG 56 2026-04-01 No No 0