Displaying 1 - 4 of 4
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
41 3481A FOLIC ACID 5MG TAB (HEA) 1000'S A 0.0079 5MG 60 2024-04-01 2026-03-31 6
40 3481AV FOLIC ACID 5MG TAB (FSB/ATB) 1000'S A 0.01 5MG 60 2022-04-01 2024-03-31 6
40 3482D LAFOL 1MG TAB (LDP/AHI) FOLIC ACID 10X10 A 0.04 1MG 60 2022-04-01 2024-03-31 6
41 3482D LAFOL 1MG TAB (LDP) FOLIC ACID 10X10 A 0.044 1MG 60 2024-04-01 2026-03-31 6