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 1261P AERRANE (BAX/STO) ISOFLURANE 250ML C 66.54 99.9% 0 2022-04-01 2024-03-31 0
41 1261P AERRANE (BAX) ISOFLURANE (C) 250ML C 58.6886 99.9% 0 2024-04-01 2026-03-31 0
40 1261S AERRANE SOLN (BAX/STO) ISOFLURANE 100ML C 34.06 99.9% 0 2022-04-01 2024-03-31 0
41 1261S AERRANE SOLN (BAX) ISOFLURANE (C) 100ML C 38.6546 99.9% 0 2024-04-01 2026-03-31 0