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 16111 TAXOTERE 20MG INJ (SFA/COL) DOCETAXEL 20MG VIAL C 135.92 20MG 0 2022-04-01 2024-03-31 0
42 16111 TAXOTERE 20MG/ML INJ (SFA) DOCETAXEL 1ML C 323.48 20MG/ML 0 2026-04-01 No No 0
40 1611N DOCETAXEL 20MG INJ (DIL/AHI) 20MG VIAL C 36.02 20MG 0 2022-04-01 2024-03-31 0
40 1611U DOCETERE 20MG INJ (DRL/AAL) DOCETAXEL 1 DS SYRNG C 39.96 20MG 0 2022-04-01 2024-03-31 0
40 16121 TAXOTERE 80MG INJ (SFA/COL) DOCETAXEL 80MG VIAL C 231.06 80MG 0 2022-04-01 2024-03-31 0
40 1612A DOCETAXEL 80MG INJ (EBA/COL) 80MG VIAL C 68.58 80MG 0 2022-04-01 2024-03-31 Price Change 0
42 1612AA DOCETAXEL 20MG/ML INJ (ZUV) 4ML BQ 28.16 20MG/ML 0 2026-04-01 No No 0
40 1612S DOCETAXEL 80MG INJ (INP/AHI) 80MG VIAL C 65.70 80MG 0 2022-04-01 2024-03-31 0
41 1612X DOCETAXEL 80MG INJ (VEN) 4ML VIAL BQ 38.4643 80MG 0 2024-04-01 2026-03-31 0