Displaying 1 - 10 of 10
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 4181A AVASTIN 25MG/ML INJ (ROC/AHI) BEVACIZUMAB 100MG VIAL C 1,003.06 25MG/ML 0 2022-04-01 2024-03-31 0
41 4181A AVASTIN 25MG/ML INJ (ROC) BEVACIZUMAB (C) 100MG VIAL C 1003.0616 25MG/ML 0 2024-04-01 2026-03-31 0
40 4181B AVASTIN 25MG/ML INJ (ROC/AHI) BEVACIZUMAB 400MG VIAL C 4,012.25 25MG/ML 0 2022-04-01 2024-03-31 0
41 4181B AVASTIN 25MG/ML INJ (ROC) BEVACIZUMAB (C) 400MG VIAL C 4012.2462 25MG/ML 0 2024-04-01 2026-03-31 0
40 4181BH BEMABIX 25MG/ML INJ (ABB/PHA) BEVACIZUMAB 4ML VIAL C 856.27 25MG/ML 0 2022-04-01 2024-03-31 0
40 4181BH BEMABIX 25MG/ML INJ (ABB/PHA) BEVACIZUMAB (C) 4ML VIAL C 856.27 25MG/ML 2022-04-01 2023-04-18 No No Delete from contract 0
40 4181BJ BEMABIX 25MG/ML INJ (ABB/PHA) BEVACIZUMAB 16ML VIAL C 3,811.28 25MG/ML 0 2022-04-01 2024-03-31 0
40 4181BJ BEMABIX 25MG/ML INJ (ABB/PHA) BEVACIZUMAB (C) 16ML VIAL C 3811.28 25MG/ML 2022-04-01 2023-03-31 No No Delete from contract 0
41 4181BR BEVACIREL 25MG/ML INJ (RLS) BEVACIZUMAB (C) 4ML VIAL C 430.5825 25MG/ML 0 2024-04-01 2026-03-31 0
41 4181BS BEVIXA 25MG/ML INJ (INC) BEVACIZUMAB (C) 4ML VIAL C 925.7524 25MG/ML 0 2024-04-01 2026-03-31 0