Displaying 1 - 10 of 10
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 58811 GLUCOBAY 50MG TAB (BSP/COL) ACARBOSE 84'S C 0.22 50MG 0 2022-04-01 2024-03-31 0
41 58811 GLUCOBAY 50MG TAB (BSP) ACARBOSE (C) 84'S C 0.2191 50MG 180 2024-04-01 2024-07-25 6
40 58816 GLUCOBAY 50MG TAB (BSP/AHI) ACARBOSE 84'S C 0.22 50MG 0 2022-04-01 2024-03-31 0
40 5881J ACARBOSE 50MG TAB (RYV/ATB) 90'S C 0.18 50MG 180 2022-04-01 2024-03-31 6
42 5881N GLUCAR 50MG TAB (GLP) ACARBOSE (C) 100'S C 0.02 50MG 180 2026-04-01 2028-03-31 No No 6
40 58821 GLUCOBAY 100MG TAB (BSP/COL) ACARBOSE 90'S C 0.40 100MG 0 2022-04-01 2024-03-31 0
41 58821 GLUCOBAY 100MG TAB (BSP) ACARBOSE (C) 90'S C 0.3975 100MG 90 2024-04-01 2024-07-25 6
40 58824 GLUCOBAY 100MG TAB (BSP/AHI) ACARBOSE 90'S C 0.40 100MG 0 2022-04-01 2024-03-31 0
41 58824 GLUCOBAY 100MG TAB (BSP) ACARBOSE (C) 90'S C 0.3975 100MG 90 2024-04-01 2026-03-31 6
40 5882G ACARBOSE 100MG TAB (LDP/AHI) 84'S C 0.29 100MG 0 2022-04-01 2024-03-31 0