Displaying 1 - 15 of 15
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 6711AL AVELOX 400MG TAB (BSP/COL) MOXIFLOXACIN 20'S C 9.11 400MG 0 2022-04-01 2024-03-31 0
41 6711AL AVELOX 400MG TAB (BSP) MOXIFLOXACIN (C) 20'S C 9.1064 400MG 0 2024-04-01 2026-03-31 0
42 6711DD AVELOX 400MG TAB (BSP) MOXIFLOXACIN 5'S C 9.11 400MG 0 2026-04-01 No No 0
40 6711EK AVELOX 400MG TAB (BSP/AHI) MOXIFLOXACIN 20'S C 9.11 400MG 0 2022-04-01 2024-03-31 0
41 6711EK AVELOX 400MG TAB (BSP) MOXIFLOXACIN (C) 20'S C 9.1064 400MG 0 2024-04-01 2026-03-31 0
42 6711EK AVELOX 400MG TAB (BSP) MOXIFLOXACIN 20'S C 6.01 400MG 0 2026-04-01 No No 0
41 6711KV OXIFLED 400MG TAB (MSN) MOXIFLOXACIN (C) 10'S C 0.7965 400MG 0 2024-04-01 2026-03-31 0
42 6711ME AVELOX 400MG TAB (BSP) MOXIFLOXACIN 5'S C 8.29 400MG 0 2026-04-01 No No 0
40 6712C AVELOX 400MG INJ (BSP/COL) MOXIFLOXACIN 250ML C 50.70 400MG 0 2022-04-01 2024-03-31 0
41 6712C AVELOX 400MG INJ (BSP) MOXIFLOXACIN (C) 250ML C 50.6967 400MG 0 2024-04-01 2026-03-31 0
42 6712C AVELOX 400MG INJ (BSP) MOXIFLOXACIN 250ML C 32.05 400MG 0 2026-04-01 No No 0
42 6712CH MOXIGET 400MG INJ (GET) MOXIFLOXACIN 10ML BQ 8.73 400MG 0 2026-04-01 No No 0
40 6712T AVELOX 400MG INJ (BSP/AHI) MOXIFLOXACIN 250ML C 50.70 400MG 0 2022-04-01 2024-03-31 0
41 6712T AVELOX 400MG INJ (BSP) MOXIFLOXACIN (C) 250ML C 50.6967 400MG 0 2024-04-01 2026-03-31 0
42 6712T AVELOX 400MG INJ (BSP) MOXIFLOXACIN 250ML C 35.20 400MG 0 2026-04-01 No No 0