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 A6812 COMBIVIR 150MG | 300MG TAB (GSK/COL) LAMIVUDINE | ZIDOVUDINE 60'S BL 2.25 150MG|300MG 0 2022-04-01 2022-05-31 Delete from contract 0
40 A681HB ZOVILAM 150MG | 300MG TAB (MAT/AHI) LAMIVUDINE | ZIDOVUDINE 60'S BL 0.35 150MG|300MG 0 2022-04-01 2024-03-31 0
40 A681HG DUOVIR 150MG | 300MG TAB (CIP/AHI) LAMIVUDINE | ZIDOVUDINE 60'S BL 0.89 150MG|300MG 0 2022-04-01 2024-03-31 0