Displaying 1 - 20 of 30
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 0081T FLUCONAZOLE 200MG INJ (BRA/COL) 100ML BQ 4.65 200MG 0 2022-04-01 2024-03-31 0
41 0081T FLUCONAZOLE 200MG INJ (BRA) (BQ) 100ML BQ 4.9202 200MG 0 2024-04-01 2026-03-31 0
42 0081T FLUCONAZOLE 200MG INJ (BRA) 100ML BQ 6.31 200MG 0 2026-04-01 No No 0
40 58615 DIFLUCAN 150MG CAP (PFI/STO) FLUCONAZOLE 1'S C 22.70 150MG 0 2022-04-01 2024-03-31 0
41 58615 DIFLUCAN 150MG CAP (PFI) FLUCONAZOLE (C) 1'S C 22.9155 150MG 60 2024-04-01 2026-03-31 6
42 58615 DIFLUCAN 150MG CAP (PFI) FLUCONAZOL 1'S C 22.92 150MG 60 2026-04-01 No No 6
40 5861AD APO-FLUCONAZOLE 50MG TAB (APO/COL) 50'S A 0.46 50MG 60 2022-04-01 2024-03-31 6
41 5861CF DILAPAN 150MG TAB (REM) FLUCONAZOLE (C) 3'S C 0.9061 150MG 60 2024-04-01 2026-03-31 6
42 5861CF DILAPAN 150MG TAB (REM) FLUCONAZOLE 3'S C 0.95 150MG 60 2026-04-01 No No 6
40 5861EG FLUCESS 150MG CAP (BCH/COL) FLUCONAZOLE 10'S C 1.12 150MG 0 2022-04-01 2024-03-31 0
40 5861EH FLUCESS 200MG CAP (BCH/COL) FLUCONAZOLE 10'S C 2.10 200MG 0 2022-04-01 2024-03-31 Price Change 0
40 5861ET FLUCONAZOLE 150MG CAP (HEA/RXP) 1'S A 0.46 150MG 60 2022-04-01 2024-03-31 6
41 5861HF FLUCESS 150MG CAP (BCH) FLUCONAZOLE (C) 1'S C 6.9045 150MG 60 2024-04-01 2026-03-31 6
42 5861HF FLUCESS 150MG CAP (BCH) FLUCONAZOLE 1'S C 21.91 150MG 60 2026-04-01 No No 6
40 5861JH FLUCONAZOLE 150MG TAB (LDP/AHI) 100'S A 0.24 150MG 60 2022-04-01 2024-03-31 6
40 5861JW FLUCONAZOLE 200MG TAB (FSB/ATB) 10'S A 0.36 200MG 60 2022-04-01 2024-03-31 Add to Contract as Cat A 6
41 5861KH FLUCONA-DENK 150MG CAP (EDK) FLUCONAZOLE 10'S A 0.2039 150MG 60 2024-04-01 2024-07-29 6
42 5861KK CANESORAL 150MG CAP (BSP) FLUCONAZ (C) 1'S C 4.89 150MG 60 2026-04-01 No No Add to Contract as Cat C 6
41 5861KQ CANEX 150MG TAB (TPP) FLUCONAZOLE 25'S A 0.1403 150MG 60 2024-04-01 2026-03-31 6
42 5861KQ CANEX 150MG TAB (TPP) FLUCONAZOLE 25'S A 0.19 150MG 60 2026-04-01 No No 6