Displaying 1 - 2 of 2
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 3791K ZYRTEC-D 5MG C/120MG P CAP (GSK/COL) CETIRIZI 10'S C 1.63 5MG|120MG 0 2022-04-01 2024-03-31 0
41 3791K ZYRTEC-D 5MG|120MG TAB (GSK) CETIRIZINE|PSEUDOEPHEDRINE (C) 10'S C 1.631 5MG|120MG 0 2024-04-01 2025-02-18 0