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 29426 HYDROXYPROGESTERONE 250MG/ML INJ (MON/PHA) 1ML AMP BQ 3.62 250MG/ML 0 2022-04-01 2024-03-31 0
41 29428 HYDROXYPROGESTERONE 250MG/ML INJ (MON) 5X1ML BQ 2.577 250MG/ML 0 2024-04-01 2026-03-31 0