Displaying 1 - 2 of 2
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 43016 PMS-PYRAZINAMIDE 500MG TAB (PMS) 100'S A 0.4241 500MG 120 2024-04-01 2026-03-31 6
40 4301K PYRAZINAMIDE 500MG TAB (CAM/AHI) 30'S A 1.00 500MG 120 2022-04-01 2024-03-31 6