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
41 39111 MINOXIDIL 2.5MG TAB (WAT) 100'S A 0.146 2.5MG 120 2024-04-01 2026-03-31 6
40 3911C MINOXIDIL 2.5MG TAB (KWA/ATB) 10X10 A 0.38 2.5MG 120 2022-04-01 2022-04-02 6
40 3911C MINOXIDIL 2.5MG TAB (KWA/ATB) 10X10 A 0.57 2.5MG 120 2022-04-03 2024-03-31 Price Change 6
41 39127 MINOXIDIL 10MG TAB (WAT) 100'S A 0.2115 10MG 120 2024-04-01 2026-03-31 6
40 3912F MINOXIDIL 10MG TAB (KWA/ATB) 10X10 A 0.49 10MG 120 2022-04-01 2022-04-02 6
40 3912F MINOXIDIL 10MG TAB (KWA/ATB) 10X10 A 0.93 10MG 120 2022-04-03 2024-03-31 Price Change 6