Displaying 1 - 6 of 6
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 A681FS EXATRON 200MG|245MG TAB (REM) EMTRICITAB (BL) 30'S BL 2.5371 200MG|245MG 0 2024-04-01 2026-03-31 0
40 A681FT TAVIN-EM 200MG | 300MG TAB (EMC/COL) EMTRICITABINE | TENOFOVIR 30'S BL 0.71 200MG|300MG 0 2022-04-01 2024-03-31 0
41 A681FT TAVIN-EM 200MG|300MG TAB (EMC) EMTRICITABINE|TENOFOVIR (BL) 30'S BL 0.9378 200MG|300MG 60 2024-04-01 2026-03-31 6
40 A681GL TRUVADA 200MG | 300MG TAB (GIL/COL) EMTRICITABINE | TENOFOVIR 30'S BL 4.32 200MG|300MG 0 2022-04-01 2024-03-31 0
40 A681HJ EMTRICITABINE | TENOFOVIR 200MG | 300MG TAB (MCP/AHI) 30'S BL 0.53 200MG|300MG 0 2022-04-01 2024-03-31 0
40 A681HL EMTRICITABINE | TENOFOVIR 200MG | 300MG TAB (MAT/AHI) 30'S BL 0.97 200MG|300MG 0 2022-04-01 2024-03-31 0