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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 5591A CERUMOL EAR DR (THR/SBI) PROPYLENE GLYCOL | TU PROPYLENE GLYCOL|TURPENTINE OIL CERUMOL 11ML A 4.35 4.35 EAR DROP 1 BOTT THR THORNTON & ROSS LTD SBI MASSY DISTRIBUTION (BDOS) LTD 5292 EENT DRUGS MISCELLANEOPUS 2022-04-01 2024-03-31 OTIC 6 EYE, EAR, NOSE AND THROAT PREPARATIONS