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
40 35215 PHYTOMENADIONE 10MG TAB (SLS/AHI) 20'S A 1.50 10MG 90 2022-04-01 2024-03-31 6
41 35215 KENADIONE 10MG TAB (SLS) PHYTOMENADIONE (C) 2X10 C 1.4978 10MG 90 2024-04-01 2026-03-31 6
41 35216 PHYTOMENADIONE 10MG TAB (KWA) 10'S A 0.8291 10MG 90 2024-04-01 2026-03-31 6
40 3522J LADION 1MG IV/IM INJ (LDP/AHI) PHYTOMENADIONE 10X0.5ML B 5.71 1MG IV/IM 0 2022-04-01 2024-03-31 0
41 3522J LADION 1MG IV/IM INJ (LDP) PHYTOMENADION (B) 10X0.5ML B 5.7085 1MG IV/IM 0 2024-04-01 2026-03-31 0
40 3523F PHYTOMENADIONE 10MG/ML IV/IM INJ (RTM/PHA) 10X1ML B 4.02 10MG/ML IV/IM 0 2022-04-01 0
40 3523F PHYTOMENADIONE 10MG/ML IV/IM INJ (RTM/PHA) 10X1ML B 1.54 10MG/ML IV/IM 0 2022-07-19 2024-03-31 Price Change 0
41 3523F PHYTOMENADIONE 10MG/ML IV/IM INJ (RTM) (B) 10X1ML B 4.1074 10MG/ML IV/IM 2 2024-04-01 2026-03-31 0