Displaying 1 - 7 of 7
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 7151AM CASODEX 150MG TAB (AZN/COL) BICALUTAMIDE 28'S C 23.39 150MG 0 2022-04-01 2024-03-31 0
41 7151AM CASODEX 150MG TAB (AZN) BICALUTAMID (C) 28'S C 23.3883 150MG 0 2024-04-01 2026-03-31 0
40 7151AN CASODEX 50MG CAP (AZN/COL) BICALUTAMIDE 28'S C 8.08 50MG 0 2022-04-01 2024-03-31 0
41 7151AN CASODEX 50MG CAP (AZN) BICALUTAMIDE (C) 28'S C 8.0822 50MG 0 2024-04-01 2026-03-31 0
40 7151P APO-BICALUTAMIDE 50MG TAB (APO/COL) 30'S C 0.59 50MG 0 2022-04-01 2024-03-31 0
40 7151R BICALUTAMIDE 150MG TAB (CIP/AHI) 30'S C 3.11 150MG 0 2022-04-01 2024-03-31 0
41 7151S BICALUTAMIDE 50MG TAB (CIP) (C) 30'S C 0.589 50MG 0 2024-04-01 2026-03-31 0