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
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