Displaying 1 - 4 of 4
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 7911Q TIZANIDINE 4MG TAB (DRL) 150'S A 0.1167 4MG 21 2024-04-01 2026-03-31 0
40 7911T TIZANIDINE 4MG TAB (KWA/ATB) 10X10 A 0.30 4MG 21 2022-04-01 2024-03-31 0
40 7911Y SIRDALUD 4MG TAB (BCH/COL) TIZANIDINE 30'S C 0.68 4MG 0 2022-04-01 2024-03-31 0
41 7911Y SIRDALUD 4MG TAB (BCH) TIZANIDINE (C) 30'S C 0.6814 4MG 21 2024-04-01 2026-03-31 0