|
|
40
|
4181G
|
HERCEPTIN 600MG SC INJ (ROC/AHI) TRASTUZUMAB
|
5ML VIAL
|
C
|
3,982.34
|
600MG
|
0
|
2022-04-01
|
2024-03-31
|
|
|
|
0
|
|
|
41
|
4181G
|
HERCEPTIN 600MG SC INJ (ROC) TRASTUZUMAB (C)
|
5ML VIAL
|
C
|
3982.3447
|
600MG
|
0
|
2024-04-01
|
2026-03-31
|
|
|
|
0
|
|
|
42
|
4181G
|
HERCEPTIN 600MG SC INJ (ROC) TRASTUZUMAB
|
5ML VIAL
|
BQ
|
3,384.99
|
600MG
|
0
|
2026-04-01
|
|
No
|
No
|
|
0
|
|
|
40
|
4181J
|
ACTEMRA 162MG/0.9ML INJ (ROC/AHI) TOCILIZUMAB
|
4X0.9ML
|
C
|
176.69
|
162MG/0.9ML
|
0
|
2022-04-01
|
2024-03-31
|
|
|
|
0
|
|
|
41
|
4181J
|
ACTEMRA 162MG/0.9ML INJ (ROC) TOCILIZUMA (C)
|
4X0.9ML
|
C
|
424.7381
|
162MG/0.9ML
|
0
|
2024-04-01
|
2026-03-31
|
|
|
|
0
|
|
|
42
|
4181J
|
ACTEMRA 162MG/0.9ML INJ (ROC) TOCILIZUMA
|
4X0.9ML
|
BQ
|
424.74
|
162MG/0.9ML
|
0
|
2026-04-01
|
|
No
|
No
|
|
0
|
|
|
41
|
4181K
|
PERJETA 420MG INJ (ROC) PERTUZUMAB (C)
|
14ML
|
C
|
8644.2703
|
420MG
|
0
|
2024-04-01
|
2026-03-31
|
|
|
|
0
|
|
|
42
|
4181K
|
PERJETA 420MG INJ (ROC) PERTUZUMAB
|
14ML
|
BQ
|
8,644.27
|
420MG
|
0
|
2026-04-01
|
|
No
|
No
|
|
0
|
|
|
41
|
4181N
|
RITUXIMAB 10MG/ML INJ (RLS) (BQ)
|
10ML
|
BQ
|
190.0108
|
10MG/ML
|
0
|
2024-04-01
|
2026-03-31
|
|
|
|
0
|
|
|
41
|
4181PB
|
SIMULECT 20MG INJ (NVS) BAILIXIMAB (C)
|
20MG VIAL
|
C
|
4892.9832
|
20MG
|
0
|
2024-04-01
|
2026-03-31
|
|
|
|
0
|
|
|
42
|
4181PB
|
SIMULECT 20MG INJ (NVS) BASILIXIMAB
|
20MG VIAL
|
C
|
4,892.98
|
20MG
|
0
|
2026-04-01
|
|
No
|
No
|
|
0
|
|
|
40
|
4181S
|
ACCENTRIX 10MG/ML INJ (NVS/COL) RANIBIZUMAB
|
1 DOSE
|
C
|
788.31
|
10MG/ML
|
0
|
2022-04-01
|
2024-03-31
|
|
|
|
0
|
|
|
41
|
4181S
|
ACCENTRIX 10MG/ML INJ (NVS) RANIBIZUMAB (C)
|
1 DOSE
|
C
|
788.314
|
10MG/ML
|
0
|
2024-04-01
|
2026-03-31
|
|
|
|
0
|
|
|
42
|
4181S
|
ACCENTRIX 10MG/ML INJ (NVS) RANIBIZUMAB
|
1 DOSE
|
C
|
788.31
|
10MG/ML
|
0
|
2026-04-01
|
|
No
|
No
|
|
0
|
|
|
40
|
4181T
|
KADCYLA 100MG/ML INJ (ROC/AHI) ADO-TRASTUZUMAB EMTANSINE
|
15ML
|
C
|
5,844.40
|
100MG/ML
|
0
|
2022-04-01
|
2024-03-31
|
|
|
|
0
|
|
|
41
|
4181T
|
KADCYLA 100MG/ML INJ (ROC) ADO-TRASTUZUMAB EMTANSINE (C)
|
15ML
|
C
|
5844.3966
|
100MG/ML
|
0
|
2024-04-01
|
2026-03-31
|
|
|
|
0
|
|
|
42
|
4181T
|
KADCYLA 100MG/ML INJ (ROC) ADO-TRASTUZUMAB EMTANSINE
|
15ML
|
C
|
5,552.18
|
100MG/ML
|
0
|
2026-04-01
|
|
No
|
No
|
|
0
|
|
|
40
|
4181U
|
KADCYLA 160MG/ML INJ (ROC/AHI) ADO-TRASTUZUMAB EMTANSINE
|
20ML
|
C
|
9,351.03
|
160MG/ML
|
0
|
2022-04-01
|
2024-03-31
|
|
|
|
0
|
|
|
41
|
4181U
|
KADCYLA 160MG/ML INJ (ROC) ADO-TRASTUZUMAB EMTANSINE (C)
|
20ML
|
C
|
9351.0346
|
160MG/ML
|
0
|
2024-04-01
|
2026-03-31
|
|
|
|
0
|
|
|
42
|
4181U
|
KADCYLA 160MG/ML INJ (ROC) ADO-TRASTUZUMAB EMTANSINE
|
20ML
|
C
|
8,883.48
|
160MG/ML
|
0
|
2026-04-01
|
|
No
|
No
|
|
0
|
