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 01916 PENICILLIN G SODIUM 1MU INJ (RTM/PHA) 15ML B 12.07 1MU 0 2022-04-01 2024-03-31 0
41 01916 PENICILLIN G SODIUM 1MU INJ (RTM) (B) 15ML B 11.4985 1MU 0 2024-04-01 2026-03-31 0
40 01924 PENICILLIN G SODIUM 5MU INJ (RTM/PHA) 15ML B 12.07 5MU 0 2022-04-01 2024-03-31 0
41 0192A PENICILLIN G SODIUM 5MU INJ (JOL) (B) 3G VIAL B 7.4754 5MU 0 2024-04-01 2026-03-31 0
42 0192A PENICILLIN G SODIUM 5MU INJ (JOL) 5G VIAL B 7.23 5MU 0 2026-04-01 No No 0