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 B5312 CANCIDAS 50MG INJ (MSD/STO) CASPOFUNGIN 50MG VIAL C 712.77 50MG 0 2022-04-01 2024-03-31 0
40 B5319 CASPOGIN 50MG INJ (CIP/AHI) CASPOFUNGIN 10ML VIAL BQ 335.28 50MG 0 2022-04-01 2024-03-31 0