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
41 7471AA FENAZINE 25MG/ML INJ (INC) FLUPHENAZINE (B) 5X1ML B 1.6799 25MG/ML 3 2024-04-01 2026-03-31 6
40 7471F FLUPHENAZINE 25MG/ML INJ (RTM/PHA) 10X1ML B 2.29 25MG/ML 0 2022-04-01 2024-03-31 0
41 7471F FLUPHENAZINE 25MG/ML INJ (RTM) FLUPHENAZ (B) 10X1ML B 2.4846 25MG/ML 3 2024-04-01 2026-03-31 6
40 7471T FLUPHENAZINE 25MG/ML INJ (MON/PHA) 10X1ML B 2.57 25MG/ML 0 2022-04-01 2024-03-31 0
40 7471U FLUPHENAZINE 25MG/ML INJ (FSB/ATB) 10X1ML B 2.23 25MG/ML 0 2022-04-01 2022-05-31 Price Change 0
41 7472AB FLUPHENAZINE 25MG/ML INJ (MON) (B) 10ML B 6.5512 25MG/ML 3 2024-04-01 2026-03-31 6
41 7472H FLUPHENAZINE 25MG/ML INJ (KWA) (B) 10ML VIAL B 4.5396 25MG/ML 3 2024-04-01 2026-03-31 6
40 7472T FLUPHENAZINE 25MG/ML INJ (LDP/AHI) 10X10ML B 4.47 25MG/ML 0 2022-04-01 2024-03-31 0
41 74738 APO-FLUPHENAZINE 1MG TAB (APO) 100'S A 0.3085 1MG 150 2024-04-01 2026-03-31 6