Displaying 1 - 4 of 4
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 A992Q DETRUSITOL SR 2MG TAB (PFI/STO) TOLTERODINE 30'S C 2.22 2MG 0 2022-04-01 2024-03-31 0
40 A992R DETRUSITOL SR 2MG TAB (PFI/SBI) TOLTERODINE 30'S C 2.22 2MG 0 2022-04-01 2024-03-31 0
40 A9933 DETRUSITOL SR 4MG TAB (PFI/SBI) TOLTERODINE 30'S C 4.44 4MG 0 2022-04-01 2024-03-31 0
40 A993G DETRUSITOL 4MG TAB (PFI/STO) TOLTERODINE 30'S C 4.44 4MG 0 2022-04-01 2024-03-31 0