Displaying 1 - 4 of 4
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 59617 KOMBIGLYZE 1G | 2.5MG TAB (AZN/COL) METFORMIN | SAXAGLIPTIN 28'S C 1.84 1G|2.5MG 0 2022-04-01 2024-03-31 0
40 59637 KOMBIGLYZE 1G | 5MG TAB (AZN/COL) METFORMIN | SAXAGLIPTIN 28'S C 1.84 1G|5MG 0 2022-04-01 2024-03-31 0
41 59637 KOMBIGLYZE 1G|5MG TAB (AZN) METFORMIN|SAXAGLIPTIN (C) 28'S C 1.9368 1G|5MG 0 2024-04-01 2026-03-31 0
42 59637 KOMBIGLYZE 1G|5MG TAB (AZN) METFORMIN|SAXAGLIPTIN 28'S C 2.03 1G|5MG 0 2026-04-01 No No 0