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 2131B LASIX 40MG TAB (SFA/COL) FRUSEMIDE 250'S A 0.10 40MG 180 2022-04-01 2024-03-31 6
41 2131B LASIX 40MG TAB (SFA) FRUSEMIDE 250'S A 0.2066 40MG 180 2024-04-01 2026-03-31 6
41 2131BJ APO-FUROSEMIDE 40MG TAB (APO) 1000'S A 0.0776 40MG 180 2024-04-01 2026-03-31 6
40 2131ZD APO-FUROSEMIDE 40MG TAB (APO/COL) 1000'S A 0.08 40MG 180 2022-04-01 2024-03-31 6
40 21322 LASIX 10MG/ML INJ (SFA/COL) FRUSEMIDE 5X2ML C 1.20 10MG/ML 0 2022-04-01 2024-03-31 0
41 21322 LASIX 10MG/ML INJ (SFA) FRUSEMIDE (C) 5X2ML C 2.7183 10MG/ML 0 2024-04-01 2026-03-31 0
40 2132AA FRUSEMIDE 10MG/ML INJ (RTM/PHA) 10X2ML B 1.01 10MG/ML 0 2022-04-01 2024-03-31 0
41 2132BG FRUSEMIDE 10MG/ML INJ (CHC) (B) 10X2ML B 0.7068 10MG/ML 0 2024-04-01 2026-03-31 0
41 2132BH FRUSEMIDE 10MG/ML INJ (FSB) (B) 50X2ML B 0.3273 10MG/ML 0 2024-04-01 2026-03-31 0