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 A061C FLUDARABINE 50MG INJ (INP/AHI) 50MG VIAL BQ 134.61 50MG 0 2022-04-01 2024-03-31 0
42 A061F FLUDARABINE 50MG INJ (KWA) 50MG VIAL BQ 626.93 50MG 0 2026-04-01 No No Add to Contract 0