Displaying 1 - 6 of 6
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 1171V ALDOMET 250MG TAB (ASG/STO) METHYLDOPA 30'S A 0.18 250MG 180 2022-04-01 2024-03-31 6
41 1171V ALDOMET 250MG TAB (ASG) METHYLDOPA 30'S A 0.3878 250MG 180 2024-04-01 2026-03-31 6
42 1171V ALDOMET 250MG TAB (ASG) METHYLDOPA 30'S A 0.46 250MG 180 2026-04-01 No No 6
40 1172K ALDOMET 500MG TAB (ASG/STO) METHYLDOPA 30'S A 0.29 500MG 180 2022-04-01 2024-03-31 6
41 1172K ALDOMET 500MG TAB (ASG) METHYLDOPA 30'S A 0.6343 500MG 180 2024-04-01 2026-03-31 6
42 1172K ALDOMET 500MG TAB (ASG) METHYLDOPA 30'S A 0.74 500MG 180 2026-04-01 No No 6