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 6031P GYNOLAX 50MG TAB (ABB/PHA) CLOMIPHENE 10'S C 0.57 50MG 0 2022-04-01 2024-03-31 0
40 6031P GYNOLAX 50MG TAB (ABB/PHA) CLOMIPHENE (C) 10'S C 0.574 50MG 2022-04-01 2023-03-31 No No Delete from contract 0
40 6031Q REJUN 50MG TAB (SGL/AHI) CLOMIPHENE 10'S C 0.42 50MG 0 2022-04-01 2024-03-31 0
41 6031R REJUN 50MG TAB (TMP) CLOMIPHENE 10'S C 0.4295 50MG 0 2024-04-01 2026-03-31 0