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 36613 LIPOFUNDIN 20% INJ (BRA/COL) SOYA BEAN OIL 500ML BQ 34.39 20% 0 2022-04-01 2024-03-31 0
41 36613 LIPOFUNDIN 20% INJ (BRA) SOYA BEAN OIL 500ML BQ 41.2642 20% 0 2024-04-01 2026-03-31 0