Displaying 1 - 4 of 4
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 6781R ETOPOSIDE 20MG/ML INJ (INP/AHI) 5ML VIAL BQ 17.21 20MG/ML 0 2022-04-01 2024-03-31 0
41 6781W ZUVITOP 20MG/ML INJ (ZUV) ETOPOSIDE 5ML VIAL BQ 12.2868 20MG/ML 40 2024-04-01 2026-03-31 0
41 67827 ZUVITOP 50MG CAP (ZUV) ETOPOSIDE 20'S BQ 1.6092 50MG 10 2024-04-01 2024-05-17 6
41 67828 ZUVITOP 50MG TAB (ZUV) ETOPOSIDE 8'S BQ 3.2925 50MG 10 2024-04-05 2026-03-31 6