Displaying 1 - 2 of 2
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 03628 ETHAMBUTOL 400MG TAB (MCP/AHI) 10X10 A 0.12 400MG 150 2022-04-01 2024-03-31 6
42 0362K ETHAMBUTOL 400MG TAB (CAD) 100'S A 0.19 400MG 150 2026-04-01 No No 6