Displaying 1 - 5 of 5
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 3631AX ACCORD METOCLOPRAMIDE 10MG TAB (INP/AAL) METO 30'S A 0.07 10MG 90 2022-04-01 2024-03-31 6
40 3631BB METOCLOPRAMIDE 10MG TAB (FSB/ATB) 500'S A 0.04 10MG 90 2022-04-01 2024-03-31 6
41 3631BB METOCLOPRAMIDE 10MG TAB (FSB) 500'S A 0.0437 10MG 90 2024-04-01 2026-03-31 6
40 3633AG METOCLOPRAMIDE 5MG/ML IV/IM INJ (MON/PHA) 10X2ML B 0.60 5MG/ML IV/IM 0 2022-04-01 2024-03-31 0
41 3633AV METOCLOPRAMIDE 5MG/ML IV/IM INJ (FSB) (B) 10X2ML B 0.4322 5MG/ML IV/IM 0 2024-04-01 2026-03-31 0