Displaying 1 - 3 of 3
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 2831FJ DAONIL 5MG TAB (SFA/COL) GLIBENCLAMIDE 100'S A 0.11 5MG 120 2022-04-01 2024-03-31 6
41 2831GT GLITISOL 5MG TAB (REM) GLIBENCLAMIDE 40'S A 0.0537 5MG 120 2024-04-01 2026-03-31 6
42 2831HD GLIFORD 5MG TAB (JLP) GLIBENCLAMIDE 200'S A 0.05 5MG 120 2026-04-01 No No 6