Displaying 1 - 8 of 8
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 05743 ENDOXAN 50MG TAB (BAX/STO) CYCLOPHOSPHAMIDE 50'S B 0.02 50MG 0 2022-04-01 2024-03-31 0
41 05743 ENDOXAN 50MG TAB (BAX) CYCLOPHOSPHAMIDE 50'S A 0.0266 50MG 240 2024-04-01 2026-03-31 6
42 05743 ENDOXAN 50MG TAB (BAX) CYCLOPHOSPHA 50'S BQ 0.07 50MG 240 2026-04-01 No No 0
40 05752 ENDOXAN 1G INJ (ASM/COL) CYCLOPHOSPHAMIDE 1G VIAL BQ 38.06 1G 0 2022-04-01 2024-03-31 0
40 05756 ENDOXAN 1G INJ (BAX/STO) CYCLOPHOSPHAMIDE 1G VIAL BQ 15.96 1G 0 2022-04-01 2024-03-31 0
41 05756 ENDOXAN 1G INJ (BAX) CYCLOPHOSPHAMIDE (BQ) 1G VIAL BQ 17.3429 1G 30 2024-04-01 2026-03-31 6
42 05756 ENDOXAN 1G INJ (BAX) CYCLOPHOSPHAMIDE 1G VIAL BQ 22.40 1G 30 2026-04-01 No No 0
41 0575F CYCLOPHOSPHAMIDE 1G INJ (KWA) (BQ) 1G VIAL BQ 10.4112 1G 30 2024-04-01 2026-03-31 6