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 5242H TRIVASTAL RETARD 50MG TAB (SER/COL) PIRIBEDIL 30'S C 0.78 50MG 0 2022-04-01 2024-03-31 0
41 5242H TRIVASTAL RETARD 50MG TAB (SER) PIRIBEDIL (C) 30'S C 0.878 50MG 30 2024-04-01 2026-03-31 60