Displaying 1 - 1 of 1
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 B2712 GALVUS 50MG TAB (NVS/COL) VIDAGLIPTIN 56'S B 0.58 50MG 60 2022-04-01 2024-03-31 6