Displaying 1 - 7 of 7
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 B011DX ZIDINE 300MG (EMC/COL) ZIDOVUDINE 60'S BL 0.32 300MG 0 2022-04-01 2024-03-31 0
40 B011EM ZIDOVIR 300MG CAP (CIP/AHI) ZIDOVUDINE 60'S BL 1.03 300MG 0 2022-04-01 2024-03-31 0
41 B0126 ZIDOVUDINE 10MG/ML SOLN (MCP) (BL) 240ML BL 0.1664 10MG/ML 100 2024-04-01 2026-03-31 6
40 B012H RETROVIR 10MG/ML SYR (GSK/COL) ZIDOVUDINE 240ML BL 0.23 10MG/ML 0 2022-04-01 2024-03-31 0
41 B012H RETROVIR 10MG/ML SYR (GSK) ZIDOVUDINE (BL) 240ML BL 0.3895 10MG/ML 100 2024-04-01 2026-03-31 6
40 B0133 RETROVIR 10MG/ML INJ (GSK/COL) ZIDOVUDINE 5X20ML C 36.35 10MG/ML 0 2022-04-01 2024-03-31 0
41 B0133 RETROVIR 10MG/ML INJ (GSK) ZIDOVUDINE 5X20ML BL 84.654 10MG/ML 0 2024-04-01 2026-03-31 0