Displaying 1 - 8 of 8
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 35715 ALOPRON 100MG TAB (REM/SBI) ALLOPURINOL 1000'S A 0.05 100MG 180 2022-04-01 2024-03-31 6
41 35715 ALOPRON 100MG TAB (REM) ALLOPURINOL 1000'S A 0.0544 100MG 180 2024-04-01 2026-03-31 6
42 35715 ALOPRON 100MG TAB (REM) ALLOPURINOL 1000'S A 0.05 100MG 180 2026-04-01 No No 6
41 3571AW APO-ALLOPURINOL 100MG TAB (APO) 1000'S A 0.0481 100MG 180 2024-04-01 2026-03-31 6
40 3571ZD APO-ALLOPURINOL 100MG TAB (APO/COL) 1000'S A 0.05 100MG 180 2022-04-01 2024-03-31 6
42 3571ZD APO-ALLOPURINOL 100MG TAB (APO) 1000'S A 0.05 100MG 180 2026-04-01 No No 6
40 3571ZV ZYLOPRIM 100MG TAB (ASG/STO) ALLOPURINOL 50'S C 0.54 100MG 0 2022-04-01 2024-03-31 0
41 3571ZV ZYLOPRIM 100MG TAB (ASG) ALLOPURINOL (C) 50'S C 0.5486 100MG 180 2024-04-01 2026-03-31 6