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 0012ER GLENCET 5MG TAB (GLP/ALI) LEVOCETIRIZINE 30'S C 0.23 5MG 0 2022-04-01 2022-03-22 Delete from contract 0
40 0012FD GLENCET 5MG TAB (GLP/ATB) LEVOCETIRIZINE 30'S C 0.23 5MG 0 2022-04-01 2024-03-31 Change Local Agent 0
40 0013AZ LEVOCETIRIZINE 2.5MG/ML SYR (CIR/AHI) 60ML C 0.10 2.5MG/ML 0 2022-04-01 2024-03-31 0