Displaying 1 - 3 of 3
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 1261Q SUPRANE (10019-641-24) (BAX/STO) DESFLURANE 240ML BQ 231.06 100% 0 2022-04-01 2024-03-31 0
41 1261Q SUPRANE (10019-641-24) (BAX) DESFLURANE (BQ) 240ML BQ 232.8788 100% 200 2024-04-01 2026-03-31 0
42 1261Q SUPRANE (10019-641-24) (BAX) DESFLURANE 240ML BQ 312.61 100% 200 2026-04-01 No No 0