Displaying 1 - 8 of 8
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
42 1011AD HEPARIN 5000U/ML INJ (RTM) 25X5ML B 9.51 5000U/ML 6 2026-04-01 2028-03-31 No No 6
40 1011AE HEPARIN 5000U/ML INJ (BRA/COL) 10X5ML B 15.70 5000U/ML 0 2022-04-01 2024-03-31 0
41 1011AE HEPARIN 5000U/ML INJ (BRA) (B) 10X5ML B 16.5818 5000U/ML 0 2024-04-01 2026-03-31 0
42 1011AE HEPARIN 5000U/ML INJ (BRA) 10X5ML B 10.11 5000U/ML 6 2026-04-01 No No 6
42 1011BF HEPAQUINT 5000U/ML INJ (JLP) HEPARIN 10X5ML B 9.30 5000U/ML 6 2026-04-01 No No 6
41 1011H HEPARIN 5000U/ML INJ (GLN) (B) 25X5ML B 10.0915 5000U/ML 0 2024-04-01 2026-03-31 0
40 1011J HEPARIN 5000U/ML INJ (RTM/PHA) 5ML VIAL B 12.23 5000U/ML 0 2022-04-01 2024-03-31 0
41 1011J HEPARIN 5000U/ML INJ (RTM) (B) 5ML VIAL B 15.3857 5000U/ML 0 2024-04-01 2026-03-31 0