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 66318 PROPOFOL 10MG/ML INJ (BRA/COL) 5X20ML BQ 2.78 10MG/ML 0 2022-04-01 2024-03-31 0
41 66318 PROPOFOL 10MG/ML INJ (BRA) (BQ) 5X20ML BQ 3.7948 10MG/ML 30 2024-04-01 2026-03-31 0
40 6631A PROPOFOL 10MG/ML INJ (BRA/COL) 50ML BQ 8.13 10MG/ML 0 2022-04-01 2024-03-31 0
41 6631A PROPOFOL 10MG/ML INJ (BRA) (BQ) 50ML BQ 8.1278 10MG/ML 30 2024-04-01 2026-03-31 0
41 6631L PROPOFOL 10MG/ML INJ (KWA) (BQ) 20ML BQ 3.561 10MG/ML 30 2024-04-01 2026-03-31 0
40 6631Q PROPOFOL 10MG/ML INJ (BAX/STO) 5X20ML C 6.65 10MG/ML 0 2022-04-01 2024-03-31 0
40 6631R OLEO-LAX 10MG/ML INJ (ABB/PHA) PROPOFOL 5X20ML C 8.83 10MG/ML 0 2022-04-01 2024-03-31 0
40 6631R OLEO-LAX 10MG/ML (ABB/PHA) PROPOFOL (C) 5X20ML C 8.834 10MG/ML 2022-04-01 2023-03-31 No No Delete from contract 0