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 5521BA AAP-MINOCYCLINE 100MG CAP (APO/COL) 100'S A 0.84 100MG 15 2022-04-01 2024-03-31 0
41 5521CL AAP-MINOCYCLINE 100MG TAB (APO) 100'S A 0.84 100MG 15 2024-04-01 2026-03-31 0
40 5521ZC AAP-MINOCYCLINE 50MG CAP (APO/COL) 100'S A 0.46 50MG 14 2022-04-01 2024-03-31 0