Displaying 1 - 12 of 12
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 0011M HISTAL 4MG TAB (CAR/COL) CHLORPHENIRAMINE 1000'S A 0.03 4MG 84 2022-04-01 2024-03-31 0
41 0011M HISTAL 4MG TAB (CAR) CHLORPHENIRAMINE 1000'S A 0.0334 4MG 84 2024-04-01 2026-03-31 0
42 0011M HISTAL 4MG TAB (CAR) CHLORPHENIRAMINE 1000'S A 0.03 4MG 84 2026-04-01 No No 0
40 0013E HISTAL 0.4MG/ML ELIX (CAR/COL) CHLORPHENIRAMI 2 LITRES A 0.02 0.4MG/ML 100 2022-04-01 2024-03-31 0
41 0013E HISTAL 0.4MG/ML ELIX (CAR) CHLORPHENIRAM 2 LITRES A 0.0231 0.4MG/ML 100 2024-04-01 2026-03-31 0
42 0013E HISTAL 0.4MG/ML ELIX (CAR) CHLORPHENIRAM 2 LITRES A 0.02 0.4MG/ML 100 2026-04-01 No No 0
40 00147 CHLORPHENIRAMINE 5MG/ML IV/IM INJ (STP/COL) 100X2ML B 1.74 5MG/ML IV/IM 0 2022-04-01 2024-03-31 0
40 0014K CHLORPHENIRAMINE 10MG/ML IV/IM INJ (MON/PHA) 10X1ML B 0.70 10MG/ML IV/IM 0 2022-04-01 2024-03-31 0
40 0014M CHLORPHENIRAMINE 10MG/ML IV/IM INJ (FSB/ATB) 10X1ML B 0.45 10MG/ML IV/IM 0 2022-04-01 2024-03-31 0
41 0014M CHLORPHENIRAMINE 10MG/ML IV/IM INJ (FSB) (B) 10X1ML B 0.3833 10MG/ML IV/IM 30 2024-04-01 2026-03-31 6
42 0014U JONCPM 10MG/ML IV/IM INJ (JLP) CHLORPHENIRAMINE 10X1ML B 0.33 10MG/ML IV/IM 30 2026-04-01 No No 6
42 0014V CHLORPHENIRAMINE 10MG/ML INJ (FSB) 10X1ML B 0.38 10MG/ML IV/IM 0 2026-04-01 No No Add to Contract as Cat B 6