11.99.99.99 |
Formulary
|
 |
Aflibercept 40mg/ml Eylea® |
11.08.02 |
Formulary
|
 |
Bevacizumab intravitreal injection Avastin® |
04.09.03 |
Formulary
|
 |
Botulinum Toxin Type A Dysport® |
04.09.03 |
Formulary
|
 |
Botulinum Toxin Type A Botox® |
13.05.03.02 |
Formulary
|
 |
Certolizumab pegol Cimzia 200mg/ml injection |
11.99.99.99 |
Formulary
|
 |
Dexamethasone 700mcg Ozurdex® |
05.03.03.02 |
Formulary
|
 |
Elbasvir/Grazoprevir Zepatier® |
11.99.99.99 |
Formulary
|
 |
Fluocinolone 190mcg/ml Iluvien® |
05.03.03.02 |
Formulary
|
 |
Ledipasvir and Sofosbuvir Harvoni® |
11.99.99.99 |
Formulary
|
 |
Ocriplasmin 0.5mg/0.2ml Jetrea® |
05.03.03.02 |
Formulary
|
 |
Ombitasvir/ paritaprevir/ ritonavir Viekirax® |
11.99.99.99 |
Formulary
|
 |
Ranibizumab 10mg/ml Lucentis® |
08.02.04 |
Formulary
|
 |
Siponimod Mayzent Tablets |
05.03.03.02 |
Formulary
|
 |
Sofosbuvir/velpatasvir/voxilaprevir Vosevi |
13.05.03.02 |
Formulary
|
 |
Tildrakizumab Ilumetri 100mg/ml injection |
01.05.03 |
Formulary
|
 |
Ustekinumab Gastroenterology |