Displaying 1 - 3 of 3
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 54814 TINIREM 500MG TAB (REM) TINIDAZOLE 10X4 A 0.2209 500MG 8 2024-04-01 2026-03-31 0
42 54814 TINIREM 500MG TAB (REM) TINIDAZOLE 10X4 A 0.22 500MG 14 2026-04-01 No No 0
40 5481Q TINIDAZOLE 500MG TAB (LAF/AHI) 40'S A 0.97 500MG 8 2022-04-01 2024-03-31 Change Local Agent 0