Displaying 1 - 2 of 2
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 2971G NEO-MERCAZOLE 5MG TAB (ANT/COL) CARBIMAZOLE CARBIMAZOLE NEO-MERCAZOLE 100'S C $16.88 $0.17 TABLET 0 TAB ANT CONCORDIA INTERNATIONAL COL COLLINS LTD 683608 ANTI-THYROID AGENTS 2022-04-01 2024-03-31 Oral 0 HORMONES AND SYNTHETIC SUBSTITUTES
40 52816 FUCITHALMIC 1% EYE DR (ANT/COL) FUSIDIC ACID FUSIDIC ACID FUCITHALMIC 5G A $14.95 $14.95 EYE DROP 1 TUBE ANT CONCORDIA INTERNATIONAL COL COLLINS LTD 520404 EENT ANTIBACTERIALS 2022-04-01 2024-03-31 OPHTHALMIC 0 EYE, EAR, NOSE AND THROAT PREPARATIONS