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
41 1691B THIORIDAZINE 10MG TAB (MAT) 100'S A 2.219 10MG 360 2024-04-01 2026-03-31 6
42 1691B THIORIDAZINE 10MG TAB (MAT) 100'S A 2.22 10MG 360 2026-04-01 No No 6
41 1692M THIORIDAZINE 25MG TAB (MAT) 100'S A 3.1206 25MG 360 2024-04-01 2026-03-31 6
42 1692M THIORIDAZINE 25MG TAB (MAT) 100'S A 3.12 25MG 360 2026-04-01 No No 6
42 1693C THIORIDAZINE 50MG TAB (MAT) 1000'S A 0.36 50MG 300 2026-04-01 No No 6