Displaying 1 - 10 of 10
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 4291AK VANCOMYCIN 500MG INJ (HET) (BQ) 10ML BQ 4.0775 500MG 56 2024-04-01 2026-03-31 0
40 4291Q VANCOMYCIN 500MG INJ (GLN/AHI) 500MG VIAL BQ 5.27 500MG 0 2022-04-01 2022-09-30 0
40 4291V VANCOMYCIN 500MG INJ (FSB/ATB) 500MG VIAL BQ 4.08 500MG 0 2022-04-01 2024-03-31 6
41 4291V VANCOMYCIN 500MG INJ (FSB) (BQ) 500MG VIAL BQ 4.1319 500MG 56 2024-04-01 2026-03-31 0
40 4291W VAREDET 500MG INJ (ABB/PHA) VANCOMYCIN 10ML VIAL C 7.99 500MG 0 2022-04-01 2024-03-31 0
40 42931 VANCOMYCIN 1G INJ (KWA/ATB) 1G VIAL BQ 20.39 1G 0 2022-04-01 2024-03-31 0
41 42931 VANCOMYCIN 1G INJ (KWA) (BQ) 1G VIAL BQ 6.9045 1G 28 2024-04-01 2025-01-28 0
41 42931 VANCOMYCIN 1G INJ (KWA) (BQ) 1G VIAL BQ 10.85 1G 28 2024-05-25 2026-03-31 0
40 42934 VANCOMYCIN 1G INJ (MON/PHA) 1G VIAL BQ 10.41 1G 0 2022-04-01 2024-03-31 6
40 42938 VANCOQURE 1G INJ (FSB/ATB) VANCOMYCIN 10ML BQ 10.85 1G 0 2022-04-01 2024-03-31 6