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
41 17635 PROMETHAZINE 25MG/ML INJ (STP) (B) 100X2ML B 2.1747 25MG/ML 30 2024-04-01 2026-03-31 0
40 17639 PROMETHAZINE 25MG/ML INJ (KWA/ATB) 5X2ML B 11.42 25MG/ML 0 2022-04-01 2024-03-31 0
40 1763L PROMETHAZINE 25MG/ML INJ (ROL/AHI) 25X1ML B 8.16 25MG/ML 0 2022-04-01 2022-09-30 0