Displaying 1 - 5 of 5
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 0321AB GENTAMICIN 40MG/ML IV/IM INJ (RTM/PHA) 10X2ML B 1.4896 40MG/ML IV/IM 0 0
40 0321AB GENTAMICIN 40MG/ML IV/IM INJ (RTM/PHA) 10X2ML B 1.25 40MG/ML IV/IM 0 2022-04-01 2022-05-31 6
40 0321AB GENTAMICIN 40MG/ML IV/IM INJ (RTM/PHA) 10X2ML B 1.93 40MG/ML IV/IM 0 2022-06-01 2024-03-31 Price Change 6
40 0321AX GENTASHIP 40MG/ML IV/IM INJ (FSB/ATB) GENTAMI 10X2ML B 0.54 40MG/ML IV/IM 0 2022-04-01 2022-07-11 6
40 0321AX GENTASHIP 40MG/ML IV/IM INJ (FSB/ATB) GENTAMI 10X2ML B 0.67 40MG/ML IV/IM 0 2022-07-12 2024-03-31 Price Change 6