Displaying 1 - 9 of 9
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 2592AD FAMOTIDINE 10MG/ML INJ (DIL/AHI) 25X2ML B 4.84 10MG/ML 0 2022-04-01 2024-03-31 0
41 2592AJ LADINE 10MG/ML INJ (LDP) FAMOTIDINE 10X2ML B 5.2029 10MG/ML 0 2024-04-01 2026-03-31 0
42 2592AM FAMOTIDINE 10MG/ML INJ (MAT) 25X2 ML BQ 5.19 10MG/ML 0 2026-04-01 No No 0
40 2593DR FAMOTIDINE 20MG TAB (APL/AHI) 100'S C 0.25 20MG 0 2022-04-01 2024-03-31 0
40 2594AL FAMOPSIN 40MG TAB (REM/SBI) FAMOTIDINE 10X10 A 0.07 40MG 30 2022-04-01 2024-03-31 6
41 2594AL FAMOPSIN 40MG TAB (REM) FAMOTIDINE 10X10 A 0.0652 40MG 30 2024-04-01 2026-03-31 6
42 2594AL FAMOPSIN 40MG TAB (REM) FAMOTIDINE 10X10 B 0.13 40MG 30 2026-04-01 No No 6
42 2594C FAMOTIDINE 40MG TAB (ZYP) 3X10 A 0.04 40MG 30 2026-04-01 No No 6
42 2594EJ FOMODIN 40MG TAB (ANC) FAMOTIDINE 10X10 A 0.05 40MG 30 2026-04-01 No No Add to Contract as Cat A 6