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Contracted Products [GENTAMICIN, 081202]
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Displaying 1 - 5 of 5
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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