Displaying 1 - 3 of 3
Contract Number Brand Code Brand Name Package Size Formulary Category Unit Price Strength Max. Reimbursable / Month Drug Contract Start Date Drug Contract End Date Restrict To Ophthalmologist Restrict To Pulmonologist Status Description Max Repeats
40 4222G ACETYLCYSTEINE 20% SOLN (DIL/AHI) 3X30ML BQ 91.27 20% 0 2022-04-01 2024-03-31 0
40 4222H MUCOSYS 20% INJ (UBI/RXP) ACETYLCYSTEINE 10ML BQ 8.83 20% 0 2022-04-01 2024-03-31 0
41 4222K ACETYLCYSTEINE 20% SOLN (KWA) 10ML VIAL BQ 23.5679 20% 3 2024-04-01 2026-03-31 Yes 12