Displaying 1 - 5 of 5
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
42 B5211 BOSENTAN 62.5MG TAB (CIP) 2X10 BQ 6.09 62.5MG 60 2026-04-01 No No 0
41 B521D SAFEBO 125MG TAB (MSN) (BQ) 60'S BQ 2.7206 125MG 0 2024-04-01 2026-03-31 0
40 B521E SAFEBO 62.5MG TAB (MSN/ATB) 60'S BQ 2.72 62.5MG 0 2022-04-01 2024-03-31 6
41 B521E SAFEBO 62.5MG TAB (MSN) (BQ) 60'S BQ 2.7206 62.5MG 60 2024-04-01 2026-03-31 6
40 B521F PMS-BOSENTAN 125MG TAB (PMS/COL) 60'S BQ 5.66 125MG 0 2022-04-01 2024-03-31 6