Displaying 1 - 6 of 6
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 B4811 VYMADA 24MG | 26MG TAB (NVS/COL) SACUBITRIL | VALSARTAN 28'S B 2.52 24MG|26MG 0 2022-04-01 2024-03-31 6
41 B4811 VYMADA 24MG|26MG TAB (NVS) SACUBITRIL|VALSARTAN (B) 28'S B 2.33 24MG|26MG 60 2024-04-01 2026-03-31 6
40 B4812 VYMADA 49MG | 51MG TAB (NVS/COL) SACUBITRIL | VALSARTAN 28'S B 2.52 49MG|51MG 0 2022-04-01 2024-03-31 6
41 B4812 VYMADA 49MG|51MG TAB (NVS) SACUBITRIL|VALSARTAN (B) 28'S B 2.33 49MG|51MG 60 2024-04-01 2026-03-31 6
40 B4813 VYMADA 97MG | 103MG TAB (NVS/COL) SACUBITRIL | VALSARTAN 28'S B 2.52 97MG|103MG 0 2022-04-01 2024-03-31 6
41 B4813 VYMADA 97MG|103MG TAB (NVS) SACUBITRIL|VALSARTAN (B) 28'S B 2.33 97MG|103MG 60 2024-04-01 2026-03-31 6