Displaying 1 - 8 of 8
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 28321 DIAMICRON MR 60MG TAB (SER/STO) GLICLAZIDE 30'S A 0.24 60MG 60 2022-04-01 2024-03-31 contract extended 6
40 2832AT DIAMICROM MR 60MG TAB (SER/COL) GLICLAZIDE 30'S A 0.24 60MG 60 2022-04-01 2024-03-31 Contract Extended 6
40 2832BP GLICLAZIDE MR 60MG TAB (SER/COL) 30'S A 0.24 60MG 60 2022-04-01 2024-03-31 Name Change 6
40 2832BP GLICLAZIDE MR 60MG TAB (SER/COL) 30'S A 0.24 60MG 60 2022-04-01 2024-03-31 Name Change 6
41 2832BP GLICLAZIDE MR 60MG TAB (SER) 30'S A 0.2465 60MG 60 2024-04-01 2026-03-31 6
41 2832BQ GLICLAZIDE MR 60MG TAB (SER) 30'S A 0.2465 60MG 60 2024-04-01 2026-03-31 6
41 2832BV APO-GLICLAZIDE 80MG TAB (APO) 100'S A 0.097 80MG 120 2024-04-01 2026-03-31 6
40 2832C APO-GLICLAZIDE 80MG TAB (APO/COL) 100'S A 0.10 80MG 120 2022-04-01 2024-03-31 6