Displaying 1 - 9 of 9
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
41 0011AA CHLORPHENIRAMINE 4MG TAB (GPC/ATB) 1000'S A 0.0169 4MG 84 0
41 0011M HISTAL 4MG TAB (CAR/COL) CHLORPHENIRAMINE 1000'S A 0.0334 4MG 84 0
40 0011M HISTAL 4MG TAB (CAR/COL) CHLORPHENIRAMINE 1000'S A 0.03 4MG 84 2022-04-01 2024-03-31 0
41 0013E HISTAL 0.4MG/ML ELIX (CAR/COL) CHLORPHENIRAMI 2 LITRES A 0.0231 0.4MG/ML 100 0
40 0013E HISTAL 0.4MG/ML ELIX (CAR/COL) CHLORPHENIRAMI 2 LITRES A 0.02 0.4MG/ML 100 2022-04-01 2024-03-31 0
40 00147 CHLORPHENIRAMINE 5MG/ML IV/IM INJ (STP/COL) 100X2ML B 1.74 5MG/ML IV/IM 0 2022-04-01 2024-03-31 0
40 0014K CHLORPHENIRAMINE 10MG/ML IV/IM INJ (MON/PHA) 10X1ML B 0.70 10MG/ML IV/IM 0 2022-04-01 2024-03-31 0
41 0014M CHLORPHENIRAMINE 10MG/ML IV/IM INJ (FSB/ATB) 10X1ML B 0.3833 10MG/ML IV/IM 30 6
40 0014M CHLORPHENIRAMINE 10MG/ML IV/IM INJ (FSB/ATB) 10X1ML B 0.45 10MG/ML IV/IM 0 2022-04-01 2024-03-31 0