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
40 77263 ZOSYN EDTA 4.5G INJ (PFI/STO) PIPERACILLIN/TA 10X4.5G C 53.40 4G|0.5G 0 2022-04-01 2024-03-31 0
41 77263 ZOSYN EDTA 4G|0.5G INJ (PFI) PIPERACILLIN|TAZOBACTAM (C) 10X4.5G C 44.5017 4G|0.5G 0 2024-04-01 2026-03-31 0
42 77263 ZOSYN EDTA 4G|0.5G INJ (PFI) PIPER (C) 10X4.5G C 54.97 4G|0.5G 28 2026-04-01 No No 0
40 7726AZY PITAZUM 4G | 0.5G INJ (LDP/AHI) PIPERACILLIN | TA 4.5G VIAL B 6.09 4G|0.5G 0 2022-04-01 2024-03-31 6
40 7726BR PIPERACILLIN | TAZOBACTAM 4G | 0.5G INJ (SLS/AHI) 4.5G VIAL B 7.94 4G|0.5G 0 2022-04-01 2024-03-31 6
40 7726BS PIPERACILLIN | TAZOBACTAM 4G | 0.5G INJ (UME/AHI) 4.5G VIAL BQ 4.46 4G|0.5G 0 2022-04-01 2022-09-30 0
42 7726CR TAZOPIP 4G|0.5G INJ (ZYD) PIPERACILLIN|TAZOBACTAM 4.5G VIAL B 4.54 4G|0.5G 28 2026-04-01 No No 0
41 7726CS PIPERACILLIN|TAZOBACTAM 4G|0.5G INJ (MON) (BQ) 4.5G VIAL BQ 4.6212 4G|0.5G 0 2024-04-01 2026-03-31 0
42 7726CX TAZCORT 4G|0.5G INJ (JLP) PIPERACILLIN|TAZOBACTAM 4.5G VIAL B 6.25 4G|0.5G 28 2026-04-01 No No 0