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 74712 DEPIXOL DEPOT 20MG/ML INJ (LUN/COL) FLUPENTHI 10X1ML B 11.80 20MG/ML 0 2022-04-01 2024-03-31 0
40 7473K DEPIXOL 3MG TAB (LUN/COL) FLUPENTHIXOL 100'S A 1.15 3MG 180 2022-04-01 2024-03-31 6