Displaying 1 - 4 of 4
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 6801F ZEVERT 8MG TAB (INP/AHI) BETAHISTINE 120'S A 0.07 8MG 90 2022-04-01 2024-03-31 6
40 6801G BETASERC 16MG TAB (ABB/PHA) BETAHISTINE 20'S C 0.63 16MG 0 2022-04-01 2024-03-31 0
40 6801G BETASERC 16MG TAB (ABB/PHA) BETAHISTINE (C) 20'S C 0.628 16MG 2022-04-01 2023-03-31 No No Delete from contract 0
41 6801H ZEVERT 16MG TAB (INP) BETAHISTINE 5X10 A 0.1577 16MG 90 2024-04-01 2026-03-31 6