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 66613 TAMBOCOR 100MG TAB (PMA/AHI) FLECAINIDE 25'S C 1.03 100MG 0 2022-04-01 2024-03-31 0
41 66615 FLECAINIDE 100MG TAB (ROL) (B) 60'S B 1.4235 100MG 90 2024-04-01 2026-03-31 6
40 66616 APO-FLECAINIDE 100MG TAB (APO/COL) 100'S B 0.45 100MG 0 2022-04-01 2024-03-31 6
42 66616 APO-FLECAINIDE 100MG TAB (APO) 100'S B 0.46 100MG 90 2026-04-01 No No 6
41 6661D FLECAINIDE 100MG TAB (LDP) (B) 20'S B 1.3469 100MG 90 2024-04-01 2026-03-31 6
41 6661F APO-FLECAINIDE 100MG TAB (APO) (B) 100'S B 0.4575 100MG 90 2024-04-01 2026-03-31 6