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
40 B021BA EMPETUS 100MG TAB (EMC/COL) RITONAVIR 30'S BL 0.73 100MG 0 2022-04-01 2024-03-31 0
41 B021BA EMPETUS 100MG TAB (EMC) RITONAVIR (BL) 30'S BL 0.8155 100MG 60 2024-04-01 2026-03-31 6
40 B021BH RITONAVIR 100MG TAB (MAT/AHI) 30'S BL 1.20 100MG 0 2022-04-01 2024-03-31 0