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 44619 RIVASTIGMINE 1.5MG CAP (DRL/AHI) 60'S C 2.39 1.5MG 0 2022-04-01 2024-03-31 0
40 4462A RIVASTIGMINE 3MG CAP (DRL/AHI) 60'S C 2.29 3MG 0 2022-04-01 2024-03-31 0
41 4463G RIVASTIGMINE 4.5MG CAP (KWA) (C) 60'S C 1.6636 4.5MG 30 2024-04-01 2026-03-31 0
40 4463J RIVASTIGMINE 4.5MG TAB (DRL/AHI) 60'S C 1.61 4.5MG 0 2022-04-01 2024-03-31 0
40 4464K RIVASTIGMINE 6MG CAP (DRL/AHI) 60'S C 1.79 6MG 0 2022-04-01 2024-03-31 0