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 5861HC ITRACONAZOLE/SECNIDAZOLE 33.3/166.6 TAB (KWA/ 10'S C 2.04 33.3MG|166.6MG 0 2022-04-01 2024-03-31 0
41 5861L SPORASEC 33.3MG|166.6MG TAB (JAC/STO) ITRACONAZOLE|SECNIDAZOLE 12'S C 3.108 33.3MG|166.6MG 0 0
40 5861L SPORASEC 33.3/166.6 TAB (JAC/STO) ITRACONAZOL 12'S C 3.11 33.3MG|166.6MG 0 2022-04-01 2024-03-31 0