Displaying 1 - 3 of 3
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 29532 DEPO-PROVERA 150MG/ML INJ (PFI/STO) MEDROXYPR 1ML VIAL C 17.51 150MG/ML 0 2022-04-01 2024-03-31 0
41 29532 DEPO-PROVERA 150MG/ML INJ (PFI) MEDROXYP (C) 1ML VIAL C 17.6691 150MG/ML 1 2024-04-01 2026-03-31 0
41 2953G MEDROXYPROGESTERONE 150MG/ML INJ (KWA) (C) 1ML VIAL C 4.8114 150MG/ML 1 2024-04-01 2026-03-31 0