Displaying 1 - 9 of 9
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 7091M CARBOPLATIN 150MG INJ (INP/AHI) 150MG VIAL BQ 36.91 150MG 0 2022-04-01 2024-03-31 0
41 7091N CARBOPLATIN 150MG INJ (FSB) (BQ) 150MG VIAL BQ 36.9692 150MG 10 2024-04-01 2026-03-31 6
42 7091V CARBOPLATIN 150MG INJ (FSB) 150MG VIAL BQ 33.44 150MG 10 2026-04-01 No No Add to Contract 0
41 7093F CARBOPLATIN 450MG INJ (DIL) (BQ) 450MG VIAL BQ 91.5803 450MG 10 2024-04-01 2026-03-31 0
40 7093L CARBOPLATIN 450MG INJ (FSB/ATB) 450MG VIAL BQ 76.11 450MG 0 2022-04-01 2024-03-31 0
41 7093L CARBOPLATIN 450MG INJ (FSB) (BQ) 450MG VIAL BQ 76.1674 450MG 10 2024-04-01 2026-03-31 0
40 7093N CARBOPLATIN 450MG INJ (INP/AHI) 450MG VIAL BQ 84.62 450MG 0 2022-04-01 2024-03-31 0
42 7093Q CARBOTHER 450MG INJ (TPP) CARBOPLAT 450MG VIAL BQ 76.11 450MG 10 2026-04-01 No No 0
42 7093S BIOCARB 450MG INJ (ZYD) CARBOPLATIN 450MG VIAL BQ 97.53 450MG 10 2026-04-01 No No 0