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
40 3151A APO-EZETIMIBE 10MG TAB (APO/COL) 100'S A 0.22 10MG 30 2022-04-01 2024-03-31 6
40 3151C EZETROL 10MG TAB (MSD/STO) EZETIMIBE 30'S C 1.58 10MG 0 2022-04-01 2024-03-31 0
41 3151C EZETROL 10MG TAB (MSD) EZETIMIBE (C) 30'S C 1.592 10MG 30 2024-04-01 2026-03-31 6
42 3151C EZETROL 10MG TAB (MSD) EZETIMIBE 30'S C 1.59 10MG 30 2026-04-01 No No 6
41 3151H APO-EZETIMIBE 10MG TAB (APO) EZETIM 100'S A 0.2218 10MG 30 2024-04-01 2026-03-31 6
42 3151K EZENTIB 10MG TAB (JLP) EZETIMIBE 10X10 A 0.33 10MG 30 2026-04-01 No No 6