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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 B021BL APO-DARUNAVIR 600MG TAB (APO/COL) 60'S BL 15.86 600MG 0 2022-04-01 2024-03-31 0
41 B021BQ APO-DARUNAVIR 600MG TAB (APO) DARUN (BL) 60'S BL 16.174 600MG 60 2024-04-01 2026-03-31 30