Displaying 1 - 7 of 7
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 3532B VITAPLEX M SYR (CAR/COL) MULTIVITAMINS 250ML B 0.05 0 2022-04-01 2024-03-31 0
41 3541AB VITALUX PLUS TAB (ALC) MULTIVITAMINS (C) 30'S C 0.9541 10000U|2MG 0 2024-04-01 2026-03-31 0
40 3544D IN FUVITE PAED INJ (BAX/STO) MULTIVITAMINS 5 PAIRS B 36.04 0 2022-04-01 2024-03-31 Price Change 0
41 3544D IN FUVITE PAED INJ (BAX) MULTIVITAMINS 5 PAIRS B 40.8782 0 2024-04-01 2026-03-31 0
40 35453 INFUVITE ADULT INJ (BAX/STO) MULTIVITAMINS 5 PAIRS B 40.23 0 2022-04-01 2024-03-31 Price Change 0
41 35453 INFUVITE ADULT INJ (BAX) MULTIVITAMINS (B) 5 PAIRS B 40.2312 0 2024-04-01 2026-03-31 0
42 35453 INFUVITE ADULT INJ (BAX) MULTIVITAMINS 5 PAIRS B 46.18 0 2026-04-01 No No 0