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 71214 FLUMAZENIL 0.1MG/ML INJ (DIL/AHI) 10X5ML B 18.07 0.1MG/ML 0 2022-04-01 2024-03-31 0
41 7121C FLUMAZENIL 0.1MG/ML INJ (LDP) 10X5ML B 15.6983 0.1MG/ML 0 2024-04-01 2026-03-31 0
42 7121F FLUMAZENIL 0.1MG/ML INJ (FSB) 5ML PFS BQ 125.40 0.1MG/ML 0 2026-04-01 No No Add to Contract 0
42 7121G FLUMAZENIL 0.1MG/ML INJ (ROL) 10X5ML BQ 265.12 0.1MG/ML 0 2026-04-02 No No Add to Contract 0