| Contract Number | Format | Brand Name | Cost /30 days | SIGCode | |
|---|---|---|---|---|---|
| 41 | CHOLESTYRAMINE 4G SACH | PMS-CHOLESTYRAMINE (PMS) | 68,91 | 1 OD | |
| 42 | DIGOXIN 0.125MG TAB | TOLOXIN (PMS) | 682,50 | ||
| 41 | DIGOXIN 0.125MG TAB | TOLOXIN (PMS) | 1 139,78 | ||
| 40 | DIGOXIN 0.125MG TABLET | TOLOXIN (PMS) | 780,00 | ||
| 42 | DIGOXIN 0.25MG TAB | DIXIN (SLS) | 5,00 | ||
| 41 | DIGOXIN 0.25MG TAB | DIXIN (SLS) | 5,00 | ||
| 40 | DIGOXIN 0.25MG TABLET | DIXIN (SLS) | 5,00 | ||
| 42 | DIGOXIN 50MCG/ML ML | PMS-TOLOXIN (PMS) | 1 704,30 | ||
| 41 | DIGOXIN 50MCG/ML ML | DIGOXIN (KWA) | 5,00 | ||
| 40 | DIGOXIN 50MCG/ML SOLUTION | TOLOXIN (PMS) | 1 928,55 | ||
| 41 | DILTIAZEM 120MG CAP | APO-DILTIAZ (APO) | 10,07 | 1 OD | |
| 42 | DILTIAZEM 120MG CAP | APO-DILTIAZ (APO) | 10,10 | 1 OD | |
| 40 | DILTIAZEM 120MG CAPSULE | APO-DILTIAZ CD (APO) | 10,10 | 1 OD | |
| 41 | DILTIAZEM 180MG CAP | APO-DILTIAZ (APO) | 12,07 | 1 OD | |
| 42 | DILTIAZEM 180MG CAP | APO-DILTIAZ (APO) | 12,20 | 1 OD | |
| 40 | DILTIAZEM 180MG CAPSULE | APO-DILTIAZ CD (APO) | 11,90 | 1 OD | |
| 42 | DILTIAZEM 240MG CAP | APO-DILTIAZ (APO) | 14,00 | 1 OD | |
| 41 | DILTIAZEM 240MG CAPCD | APO-DILTIAZ (APO) | 13,99 | 1 OD | |
| 40 | DILTIAZEM 240MG CAPSULE | APO-DILTIAZ CD (APO) | 13,70 | 1 OD | |
| 41 | DILTIAZEM 60MG TAB | AAP-DILTIAZ (APO) | 14,98 | 1 TD | |