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 4181S ACCENTRIX 10MG/ML INJ (NVS/COL) RANIBIZUMAB 1 DOSE C 788.31 10MG/ML 0 2022-04-01 2024-03-31 0
41 4181S ACCENTRIX 10MG/ML INJ (NVS) RANIBIZUMAB (C) 1 DOSE C 788.314 10MG/ML 0 2024-04-01 2026-03-31 0