Displaying 1 - 9 of 9
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 21411 ALDACTONE 25MG TAB (PFI/STO) SPIRONOLACTONE 100'S C 0.59 25MG 0 2022-04-01 2024-03-31 0
41 21411 ALDACTONE 25MG TAB (PFI) SPIRONOLACTONE (C) 100'S C 0.5352 25MG 120 2024-04-01 2026-03-31 6
40 2141AK SPIRONOLACTONE 25MG TAB (KWA/ATB) 10X10 A 0.07 25MG 120 2022-04-01 2022-09-30 6
40 2141X SPIROLON 25MG TAB (REM/SBI) SPIRONOLACTONE 1000'S A 0.08 25MG 120 2022-04-01 2024-03-31 6
41 2141X SPIROLON 25MG TAB (REM) SPIRONOLACTONE 1000'S A 0.0749 25MG 120 2024-04-01 2026-03-31 6
40 21423 SPIROLON 100MG TAB (REM/SBI) SPIRONOLACTONE 10x10 A 0.27 100MG 120 2022-04-01 2024-03-31 6
41 21423 SPIROLON 100MG TAB (REM) SPIRONOLACTONE 10x10 A 0.246 100MG 120 2024-04-01 2026-03-31 6
40 2142N ALDACTONE 100MG TAB (PFI/STO) SPIRONOLACTONE 10'S C 1.91 100MG 0 2022-04-01 2024-03-31 0
41 2142N ALDACTONE 100MG TAB (PFI) SPIRONOLACTONE (C) 10'S C 1.7805 100MG 120 2024-04-01 2026-03-31 6