Displaying 1 - 2 of 2
  • Print
Contract Number Brand Code Brand Name Active Ingredient Trade Name Package Size Formulary Category Pkg Price Unit Price Unit Description Max. Reimbursable Quantity / Month Package Description Manufacturer Code Manufacturer Name Agent Code Agent Name Benefit Therapeutic Code Therapeutic Desc Drug Contract Start Date Drug Contract End Date Status Description Default Route Max Repeats Therapeutic Head Amend Date
40 7361Q BINOCRIT 4000U INJ (BCH/COL) EPOIETIN ALPHA EPOIETIN ALPHA BINOCRIT 6X4000U BQ 125.70 20.95 INJECTION 0 VIAL BCH SANDOZ COL COLLINS LTD 2016 HEMATOPOIETIC 2022-04-01 2024-03-31 IV 0 BLOOD FORMATION, COAGULATION AND THROMBOSIS
41 7361Q BINOCRIT 4000U INJ (BCH) EPOIETIN ALPHA (BQ) EPOIETIN ALPHA BINOCRIT 6X4000U BQ 126.67 21.1123 VIAL 7 BOX BCH SANDOZ COL COLLINS LTD 2016 HEMATOPOIETIC 2024-04-01 2026-03-31 SC 0 HEMATOPOIETIC