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 0681Q UNICRISTINE 1MG INJ (UBI/RXP) VINCRISTINE 1MG VIAL BQ 7.07 1MG 0 2022-04-01 2024-03-31 0
42 0681S BIOCRISTIN INJ (ZYD) 1ML VIAL BQ 13.70 1MG/ML 8 2026-04-01 No No 0