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 48619 AAP-DESMOPRESSIN 10MCG/DOSE NASAL SOL (APO/COL) 2.5ML BQ 47.19 10MCG/DOSE 2 2022-04-01 2024-03-31 6
41 4861B AAP-DESMOPRESSIN 10MCG/DOSE NASAL SOL (APO) 2.5ML BQ 48.1415 10MCG/ML 2 2024-04-01 2026-03-31 6
40 48638 MINIRIN 4MCG/ML INJ (FER/STO) DESMOPRESSIN 10X1ML BQ 17.13 4MCG/ML 0 2022-04-01 2024-03-31 0
41 48638 MINIRIN 4MCG/ML INJ (FER) DESMOPRESSIN 10X1ML BQ 18.683 4MCG/ML 0 2024-04-01 2026-03-31 0
40 4864B MINIRIN MELT 120MCG WAFER (FER/STO) DESMOPRES 30'S B 3.88 120MCG 0 2022-04-01 2024-03-31 6
41 4864B MINIRIN MELT 120MCG WAFER (FER) DESMOPRE (BQ) 30'S BQ 4.1155 120MCG 30 2024-04-01 2026-03-31 6
40 4864C AAP-DESMOPRESSIN 0.2MG TAB (APO/COL) DESMOPRE 100'S B 0.40 0.2MG 120 2022-04-01 2024-03-31 6
41 4864D APO-DESMOPRESSIN 0.2MG TAB (APO) DE (B) 100'S B 0.4124 0.2MG 120 2024-04-01 2026-03-31 6