|
|
40
|
4701AU
|
SYSTANE BALANCE 0.6% EYE DR (ALC/AHI) PROPYLE
|
10ML
|
C
|
19.03
|
0.6%
|
0
|
2022-04-01
|
2024-03-31
|
|
|
|
0
|
|
|
41
|
4701AU
|
SYSTANE BALANCE 0.6% EYE DR (ALC) PROPYL (C)
|
10ML
|
C
|
21.6922
|
0.6%
|
1
|
2024-04-01
|
2026-03-31
|
|
|
|
0
|
|
|
42
|
4701AU
|
SYSTANE BALANCE 0.6% EYE DR (ALC) P
|
10ML
|
C
|
20.63
|
0.6%
|
1
|
2026-04-01
|
2028-03-31
|
No
|
No
|
|
0
|
|
|
40
|
4701AV
|
REFRESH OPTIVE GEL 1% | 0.9% EYE DR (ALL/COL) CARBOXYMETHYLCELLULOSE | GLYCERINE
|
10ML
|
C
|
12.91
|
1%|0.9%
|
0
|
2022-04-01
|
2024-03-31
|
|
|
|
0
|
|
|
41
|
4701AV
|
REFRESH OPTIVE GEL 1%|0.9% EYE DR (ALL) CARBOXYMETHYLCELLULO (C)
|
10ML
|
C
|
12.912
|
1%|0.9%
|
0
|
2024-04-01
|
2026-03-31
|
|
|
|
0
|
|
|
42
|
4701AV
|
REFRESH OPTIVE GEL 1%|0.9% EYE DR (ALL) CARBOXYMETHYLCELLULO
|
10ML
|
C
|
12.91
|
1%|0.9%
|
0
|
2026-04-01
|
|
No
|
No
|
|
0
|
|
|
40
|
4701AX
|
SYSTEAR 0.4% | 0.3% EYE DR (ARP/AHI) POLYETHYLENE GLYCOL 400 | PROPYLENE GLYCOL
|
10ML
|
A
|
7.34
|
0.4%|0.3%
|
1
|
2022-04-01
|
2024-03-31
|
|
|
|
6
|
|
|
41
|
4701AX
|
SYSTEAR 0.4%|0.3% EYE DR (ARP) POLYETHYLENE GLYCOL 400|PROPY
|
10ML
|
A
|
7.421
|
0.4%|0.3%
|
1
|
2024-04-01
|
2026-03-31
|
|
|
|
6
|
|
|
42
|
4701AX
|
SYSTEAR 0.4%|0.3% EYE DR (ARP) POLYETHYLENE GLYCOL 400|PROPY
|
10ML
|
A
|
8.10
|
0.4%|0.3%
|
1
|
2026-04-01
|
|
No
|
No
|
|
6
|
|
|
40
|
4701AY
|
DRYLIEF 1% EYE DR (ARP/AHI) CARBOXYMETHYLCELL
|
10ML
|
A
|
6.93
|
1%
|
1
|
2022-04-01
|
2024-03-31
|
|
|
|
6
|
|
|
41
|
4701AY
|
DRYLIEF 1% EYE DR (ARP) CARBOXYMETH
|
10ML
|
A
|
6.823
|
1%
|
1
|
2024-04-01
|
2026-03-31
|
|
|
|
6
|
|
|
40
|
4701AZ
|
DEXTRAN | HYPROMELLOSE 0.1% | 0.3% EYE DR (FSB/AT
|
15ML
|
A
|
5.41
|
0.1%|0.3%
|
1
|
2022-04-01
|
2024-03-31
|
|
|
|
6
|
|
|
40
|
4701B
|
REFRESH TEARS 0.5% EYE DR (ALL/COL) HYPROMELL
|
15ML
|
C
|
11.55
|
0.5%
|
0
|
2022-04-01
|
2024-03-31
|
|
|
|
0
|
|
|
41
|
4701B
|
REFRESH TEARS 0.5% EYE DR (ALL) CARBOXYMETHYLCELLULOSE (C)
|
15ML
|
C
|
11.5529
|
0.5%
|
0
|
2024-04-01
|
2026-03-31
|
|
|
|
0
|
|
|
42
|
4701B
|
REFRESH TEARS 0.5% EYE DR (ALL) CARBOXYMETHYLCELLULOSE
|
15ML
|
C
|
11.55
|
0.5%
|
1
|
2026-04-01
|
|
No
|
No
|
|
0
|
|
|
41
|
4701BA
|
AUCIC 1% EYE DR (LPO) CARBOXYMETHYLCELLULOSE
|
10ML
|
A
|
8.2637
|
1%
|
1
|
2024-04-01
|
2026-03-31
|
|
|
|
6
|
|
|
41
|
4701BB
|
FILTEAR 0.4%|0.3% EYE DR (INC) POLYETHYLENE GLYCOL|PROPYLENE
|
10ML
|
A
|
8.1822
|
0.4%|0.3%
|
1
|
2024-04-01
|
2026-03-31
|
|
|
|
6
|
|
|
42
|
4701BE
|
I-DEW SOOTHE 0.5% EYE DR (DCI) CARBOXYMETHYLCELLULOSE
|
15ML
|
A
|
6.42
|
0.5%
|
1
|
2026-04-01
|
|
No
|
No
|
|
6
|
|
|
42
|
4701BG
|
LOC TEARS FUSION 1% EYE DR (ADO) CARBOXYMETHYLCELLULOSE
|
15ML
|
A
|
5.16
|
1%
|
1
|
2026-04-01
|
|
No
|
No
|
|
6
|
|
|
42
|
4701BR
|
CARBOXYMETHYLCELLULOSE 0.5% EYE DR (CHC)
|
15ML
|
A
|
2.75
|
0.5%
|
1
|
2026-04-01
|
|
No
|
No
|
Add to Contract as Cat A
|
6
|
