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
40 A151A ADENOSINE 3MG/ML INJ (KWA/ATB) 10X2ML BQ 4.76 3MG/ML 0 2022-04-01 2024-03-31 0
41 A151F ADENOSINE 3MG/ML INJ (LDP) (BQ) 10X2ML BQ 5.1376 3MG/ML 30 2024-04-01 2026-03-31 0
40 A151H ADENOSINE 3MG/ML INJ (MON/PHA) 10X2ML BQ 5.21 3MG/ML 0 2022-04-01 2024-03-31 0
42 A151H ADENOSINE 3MG/ML INJ (MON) 10X2ML BQ 1.78 3MG/ML 30 2026-04-01 No No 0
42 A151N CARDIUREX 3MG/ML INJ (JLP) ADENOSINE 30X2ML BQ 1.92 3MG/ML 30 2026-04-01 No No 0