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 41011 ZOMETA 4MG INJ (NVS/COL) ZOLENDRONIC ACID 4MG VIAL C 842.68 4MG 0 2022-04-01 2024-03-31 0
41 41011 ZOMETA 4MG INJ (NVS) ZOLENDRONIC ACID (C) 4MG VIAL C 706.7642 4MG 2 2024-04-01 2026-03-31 6
42 41011 ZOMETA 4MG INJ (NVS) ZOLENDRONIC ACID 4MG VIAL C 706.76 4MG 2 2026-04-01 No No 6
41 41016 ZOLENDRONIC ACID 4MG INJ (ZUV) (BQ) 4MG VIAL BQ 13.5916 4MG 2 2024-04-01 2026-03-31 6
42 41016 ZOLENDRONIC ACID 4MG INJ (ZUV) 4MG VIAL BQ 8.54 4MG 2 2026-04-01 No No 0
40 4101A ZOLENDRONIC ACID 4MG INJ (SLS/AHI) 4MG VIAL BQ 38.95 4MG 0 2022-04-01 2022-09-30 0
41 4101A ZOLENDRONIC ACID 4MG INJ (SLS) (BQ) 4MG VIAL BQ 30.418 4MG 2 2024-04-01 2024-05-27 6
40 4101E ZOLASTA 4MG INJ (INP/AHI) ZOLENDRONIC ACID 5ML BQ 35.07 4MG 0 2022-04-01 2024-03-31 0
42 4101Q ZOLOSTEO 4MG INJ (JLP) ZOLENDRONIC ACID 12X4MG BQ 9.06 4MG 2 2026-04-01 No No 0