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 A2921 ARAVA 20MG TAB (SFA/COL) LEFLUNOMIDE 30'S C 3.17 20MG 0 2022-04-01 2024-03-31 0
41 A2921 ARAVA 20MG TAB (SFA) LEFLUNOMIDE (C) 30'S C 3.1714 20MG 0 2024-04-01 2026-03-31 0