Displaying 1 - 7 of 7
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 A3221 APO-FLUOXETINE 20MG CAP (APO/COL) 100'S A 0.08 20MG 120 2022-04-01 2024-03-31 6
40 A322HL FLUOXETINE 20MG CAP (APL/AHI) 100'S A 0.11 20MG 120 2022-04-01 2024-03-31 6
40 A322JN FLUNIL 20MG TAB (INP/AAL) FLUOXETINE 30'S C 0.20 20MG 0 2022-04-01 2024-03-31 0
41 A322JN FLUNIL 20MG TAB (INP) FLUOXETINE 30'S A 0.0797 20MG 42 2024-04-01 2026-03-31 6
40 A322KN FLUOXETINE 20MG TAB (APL/AHI) 1000'S A 0.12 20MG 120 2022-09-20 2024-03-31 Package Size Change 6
41 A322LC APO-FLUOXETINE 20MG TAB (APO) 100'S A 0.0777 20MG 42 2024-04-01 2026-03-31 6
41 A322LX FLUNIL 20MG CAP (INP) FLUOXETINE 3X10 A 0.0797 20MG 42 2024-04-01 2026-03-31 6