Displaying 1 - 3 of 3
  • Print
Contract Number Brand Code Brand Name Active Ingredient Trade Name Package Size Formulary Category Pkg Price Unit Price Unit Description Max. Reimbursable Quantity / Month Package Description Manufacturer Code Manufacturer Name Agent Code Agent Name Benefit Therapeutic Code Therapeutic Desc Drug Contract Start Date Drug Contract End Date Status Description Default Route Max Repeats Therapeutic Head Amend Date
40 A7017 PILOCARPINE | TIMOLOL 2% | 0.5% EYE DR (FSB/ATB) PILOCARPINE|TIMOLOL PILOCARPINE|TIMOLOL 5ML A 5.76 5.76 EYE DROP 1 BOTT FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD B 524092 ANTIGLAUCOMA AGENTS MISCELLANEOUS 2022-04-01 2024-03-31 Price Change Ophthalmic 6 EYE, EAR, NOSE AND THROAT PREPARATIONS 2021-12-08
42 A7019 PILOCARPINE|TIMOLOL 2%|0.5% EYE DR (CHC) PILOCARPINE|TIMOLOL PILOCARPINE|TIMOLOL 5ML A 19.52 19.52 BOTT 1 CHC CARITAS HEALTHCARE PVT LTD STO BRYDEN STOKES LTD B 524092 ANTIGLAUCOMA AGENTS MISCELLANEOUS 2026-04-01 Add to Contract as Cat A OPHTHALMIC 6 ANTIGLAUCOMA AGENTS MISCELLANEOUS 2026-03-05
40 A7026 PILOCARPINE | TIMOLOL 4% | 0.5% EYE DR (FSB/ATB) PILOCARPINE|TIMOLOL PILOCARPINE|TIMOLOL 5ML A 7.04 7.04 EYE DROP 1 BOTT FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD B 524092 ANTIGLAUCOMA AGENTS MISCELLANEOUS 2022-04-01 2024-03-31 Price Change Ophthalmic 6 EYE, EAR, NOSE AND THROAT PREPARATIONS 2021-12-08