Displaying 1 - 8 of 8
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 1642G HALOPERIDOL 5MG/ML INJ (STP/COL) 100X1ML B 1.66 5MG/ML 0 2022-04-01 2024-03-31 0
41 1642G HALOPERIDOL 5MG/ML INJ (STP) (B) 100X1ML B 1.93 5MG/ML 0 2024-04-01 2026-03-31 6
41 1642U HALOPERIDOL 5MG/ML INJ (FSB) (B) 10X1ML B 0.5899 5MG/ML 0 2024-04-01 2026-03-31 6
40 1642X HALOPERIDOL 5MG/ML INJ (MON/PHA) 10X1ML B 0.62 5MG/ML 0 2022-04-01 2024-03-31 0
40 16441 HALOXEM 5MG TAB (REM/SBI) HALOPERIDOL 1000'S A 0.07 5MG 180 2022-04-01 2024-03-31 6
41 16441 HALOXEN 5MG TAB (REM) HALOPERIDOL 1000'S A 0.071 5MG 180 2024-04-01 2026-03-31 6
40 1644T HALDOL 5MG TAB (JAC/STO) HALOPERIDOL 20'S C 1.61 5MG 0 2022-04-01 2024-03-31 0
41 1644T HALDOL 5MG TAB (JAC) HALOPERIDOL (C) 20'S C 1.6133 5MG 180 2024-04-01 2026-03-31 6