Displaying 1 - 3 of 3
  • Print
Contract Number Brand Code Brand Name Active Ingredient Trade Name Package Size Formulary Category Pkg Price Unit Price Unit Description Max. Reimbursable Quantity / Month Package Description Manufacturer Code Manufacturer Name Agent Code Agent Name Benefit Therapeutic Code Therapeutic Desc Drug Contract Start Date Drug Contract End Date Status Description Default Route Max Repeats Therapeutic Head Amend Date
40 49511 FERRUM FOL CHEWABLE 100/350 TAB (VFI/AHI) IRO FOLIC ACID|IRON 3 HYDROXY POLYMALTOSE FERRUM FOL CHEWABLE 30'S C 33.87 1.13 TABLET 0 TAB VFI VIFOR (INTERNATIONAL) INC, AHI ARMSTRONG HEALTHCARE INC 200404 IRON PREPARATIONS 2022-04-01 2022-09-30 Oral 0 BLOOD FORMATION, COAGULATION AND THROMBOSIS 2022-03-29
40 50011 FERRUM CHEWABLE 100MG TAB (VFI/AHI) IRON 3 HY IRON 3 HYDROXY POLYMALTOSE FERRUM CHEWABLE 30'S A 37.65 1.26 TABLET 30 TAB VFI VIFOR (INTERNATIONAL) INC, AHI ARMSTRONG HEALTHCARE INC 200404 IRON PREPARATIONS 2022-04-01 2024-03-31 Oral 6 BLOOD FORMATION, COAGULATION AND THROMBOSIS
40 50031 FERRUM 50MG/ML DROPS (VFI/AHI) IRON 3 HYDROXY IRON 3 HYDROXY POLYMALTOSE FERRUM 30ML C 33.98 33.98 DROPS 0 BOTT VFI VIFOR (INTERNATIONAL) INC, AHI ARMSTRONG HEALTHCARE INC 200404 IRON PREPARATIONS 2022-04-01 2024-03-31 TOPICAL 0 BLOOD FORMATION, COAGULATION AND THROMBOSIS