Displaying 1 - 17 of 17
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 0451A CO-TRIMOXAZOLE 400MG | 80MG TAB (HEA/RXP) SULFA 10X10 A 0.07 400MG|80MG 56 2022-04-01 2024-03-31 0
42 0451BW CO TRIMOX EZE 400MG|80MG TAB (INF) SULFAMETHOXAZOLE|TRIMETHO 10X10 A 0.07 400MG|80MG 56 2026-04-01 No No 0
42 0451BY SULFAMETHOXAZOLE|TRIMETHOPRIM 400MG|80MG TAB (STL) 500'S A 0.04 400MG|80MG 56 2026-04-01 No No 0
42 0451BZ COTRIMOXAZOLE 400MG|80MG TAB (HEA) SULFAMETHOXAZOLE|TRIMETHO 10X10 A 0.07 400MG|80MG 56 2026-04-01 No No Price Change 0
42 0451CA CO-TRIMOXAZOLE 400MG|80MG TAB (HEA) SULFAMETHOXAZOLE|TRIMETH 10X10 A 0.07 400MG|80MG 56 2026-04-01 No No Add to Contract as Cat A 0
42 0451CB CO-TRIMOXAZOLE 400MG|80MG TAB (HEA) SULFAMETHOXAZOLE|TRIMETH 10X10 A 0.07 400MG|80MG 56 2026-04-01 No No Add to Contract as Cat A 0
41 0451EX CO-TRIMOXAZOLE 400MG|80MG TAB (HEA) SULFAMETHOXAZOLE|TRIMETH 10X10 A 0.0726 400MG|80MG 56 2024-04-01 2026-03-31 0
41 0451Z BACTRIM FORTE 800MG|160MG TAB (ROC) SULFAMETHOXAZOLE|TRIMETH (B) 10'S B 1.1417 800MG|160MG 28 2024-04-01 2026-03-31 0
42 0452AT CO-TRIMOXAZOLE 40MG/ML|8MG/ML SUSP (CIR) SULFAMETHOXAZOLE|TR 100ML A 0.05 40MG/ML|8MG/ML 200 2026-04-01 No No 0
40 0452E SULFATRIM 40MG/ML | 8MG/ML SUSP (CAR/COL) SULFAMETHOXAZOLE | TRIMETHOPRIM 100ML A 0.06 40MG/ML|8MG/ML 200 2022-04-01 2024-03-31 0
41 0452E SULFATRIM 40MG/ML|8MG/ML SUSP (CAR) SULFAMETHOXAZOLE|TRIMETH 100ML A 0.0612 40MG/ML|8MG/ML 200 2024-04-01 2026-03-31 0
42 0452E SULFATRIM 40MG/ML|8MG/ML SUSP (CAR) SULFAMETHOXAZOLE|TRIMETH 100ML A 0.06 40MG/ML|8MG/ML 200 2026-04-01 No No 0
41 04536 BACTRIM 80MG|16MG/ML INJ (ROC) SULFAMETHOXAZOLE|TRIMETHOPRIM (C) 10X5ML C 1.0602 80MG|16MG/ML 0 2024-04-01 2026-03-31 0
40 0453C CO-TRIMOXAZOLE 80MG/ML | 16MG/ML INJ (MON/PHA) 5X5ML B 2.01 80MG|16MG/ML 0 2022-04-01 2024-03-31 0
42 0453C CO-TRIMOXAZOLE 80MG/ML|16MG/ML INJ (MON) SULFAMETHOXAZOLE|TR 5X5ML B 1.60 80MG/ML|16MG/ML 20 2026-04-01 No No 0
40 0453D CO-TRIMOXAZOLE 80MG/ML | 16MG/ML INJ (KWA/ATB) 5X5ML B 3.53 80MG|16MG/ML 0 2022-04-01 2024-03-31 0
41 0453D CO-TRIMOXAZOLE 80MG/ML|16MG/ML INJ (KWA) SULFAMETHOXAZOLE|TR (B) 5X5ML B 0.8209 80MG/ML|16MG/ML 20 2024-04-01 2026-03-31 0