Displaying 1 - 7 of 7
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 1181AJ APO-SOTALOL 80MG TAB (APO/COL) 100'S A 0.11 80MG 90 2022-04-01 2024-03-31 6
42 1181AJ APO-SOTALOL 80MG TAB (APO) 100'S A 0.11 80MG 90 2026-04-01 No No 6
41 1181CF PMS-SOTALOL 80MG TAB (PMS) 100'S A 0.1767 80MG 90 2024-04-01 2026-03-31 6
41 1181FP APO-SOTALOL 80MG TAB (APO) 100'S A 0.1109 80MG 90 2024-04-01 2026-03-31 6
40 1182AN APO-SOTALOL 160MG TAB (APO/COL) 100'S A 0.16 160MG 60 2022-04-01 2024-03-31 6
42 1182AN APO-SOTALOL 160MG TAB (APO) 100'S A 0.17 160MG 60 2026-04-01 No No 6
41 1182FC APO-SOTALOL 160MG TAB (APO) 100'S A 0.1664 160MG 60 2024-04-01 2026-03-31 6