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
42 12413 APO-RALOXIFENE 60MG TAB (APO) 100'S C 0.97 60MG 0 2026-04-01 No No 0
40 1241E RALOXIFENE 60MG TAB (DRL/AHI) 30'S C 1.33 60MG 0 2022-04-01 2024-03-31 0
41 1241F APO-RALOXIFENE 60MG TAB (APO) 100'S C 0.9704 60MG 0 2024-04-01 2026-03-31 0