Displaying 1 - 2 of 2
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 31712 ENBREL 50MG INJ (PFI/STO) ETANERCEPT 4X50MG C 741.70 50MG 0 2022-04-01 2024-03-31 0
41 31712 ENBREL 50MG INJ (PFI) ETANERCEPT (C) 4X50MG C 748.9662 50MG 1 2024-04-01 2026-03-31 6