|
|
40
|
12116
|
ANGIRON 0.5MG SL TAB (CIR/AHI) GLYCERYL TRINI
|
30'S
|
A
|
11.53
|
0.5MG SL
|
30
|
2022-04-01
|
2024-03-31
|
|
|
|
6
|
|
|
40
|
12121
|
MINITRAN 5MG PATCH (PMA/AHI) GLYCERYL TRINITR
|
30'S
|
BQ
|
46.21
|
5MG
|
0
|
2022-04-01
|
2024-03-31
|
|
|
|
6
|
|
|
41
|
12121
|
MINITRAN 5MG PATCH (PMA) GLYCERYL TRINIT (BQ)
|
30'S
|
BQ
|
54.3665
|
5MG
|
6
|
2024-04-01
|
2026-03-31
|
|
|
|
0
|
|
|
40
|
1212F
|
NITRODERM TTS 5 25MG PATCH (BCH/COL) GLYCERYL
|
10'S
|
BQ
|
19.68
|
25MG
|
0
|
2022-04-01
|
2022-05-24
|
|
|
Delete from contract
|
0
|
|
|
40
|
1212G
|
NITRODERM TTS 10 50MG PATCH (BCH/COL) GLYCERY
|
10'S
|
BQ
|
45.40
|
50MG
|
0
|
2022-04-01
|
2022-05-24
|
|
|
Delete from contract
|
6
|
|
|
41
|
12136
|
NITROGLYCERINE 5MG/ML INJ (SLS) GLYCERYL (BQ)
|
25X5ML
|
BQ
|
6.8502
|
5MG/ML
|
0
|
2024-04-01
|
2026-03-31
|
|
|
|
0
|
|
|
40
|
12138
|
GLYCERYL TRINITRATE 5MG/ML INJ (MON/PHA)
|
5X5ML
|
BQ
|
1.89
|
5MG/ML
|
0
|
2022-04-01
|
2024-03-31
|
|
|
|
0
|
|
|
41
|
12138
|
GLYCERYL TRINITRATE 5MG/ML INJ (MON (BQ)
|
5X5ML
|
BQ
|
1.7778
|
5MG/ML
|
0
|
2024-04-01
|
2026-03-31
|
|
|
|
0
|
|
|
40
|
12148
|
NITROCARD 0.4MG SPRAY (ARP/AHI) GLYCERYL TRIN
|
200 DOSES
|
A
|
17.61
|
0.4MG
|
1
|
2022-04-01
|
2024-03-31
|
|
|
|
6
|
|
|
41
|
12149
|
TROCER 0.4MG SPRAY (INC) GLYCERYL TRINITRATE
|
200 DOSES
|
A
|
18.2671
|
0.4MG
|
1
|
2024-04-01
|
2026-03-31
|
|
|
|
6
|
