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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 40712 TIMOLOL EX 0.25% EYE DR (FSB/ATB) TIMOLOL EX TIMOLOL EX 5ML A 1.09 1.09 EYE DROP 1 BOTT FSB FLAGSHIP BIOTECH ATB ANSA TRADING BARBADOS LTD B 524008 EENT BETA ADRENERGIC AGENTS 2022-04-01 2024-03-31 Price Change Ophthalmic 6 EYE, EAR, NOSE AND THROAT PREPARATIONS 2021-12-08