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
40 B5012 ANORO ELLIPTA 55/22 INHR (GSK/COL) UMECLIDINI 30 DOSES BQ 141.60 55MCG|22MCG 1 2022-04-01 2024-03-31 6
41 B5012 ANORO ELLIPTA 55MCG|22MCG INHR (GSK) UMECLIDINIUM|VILANTEROL (BQ) 30 DOSES BQ 108.6786 55MCG|22MCG 1 2024-04-01 2024-07-16 Yes 6
41 B5012 ANORO ELLIPTA 55MCG|22MCG INHR (GSK) UMECLIDINIUM|VILANTEROL (BQ) 30 DOSES BQ 163.94 55MCG|22MCG 1 2024-07-17 2026-03-31 Yes 6