Displaying 1 - 4 of 4
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 91331 ALCOHOL SMALL (WIR/WIR) 1 LITRE B 0.01 0 2022-04-01 2024-03-31 Price Change 0
41 91331 ALCOHOL SMALL (WIR) ALCOHOL 1 LITRE B 0.0073 1000 2024-04-01 2026-03-31 6
40 91341 ALCOHOL LARGE (WIR/WIR) 1 LITRE B 0.01 0 2022-04-01 2022-09-30 Price Change 0
41 91341 ALCOHOL LARGE (WIR) ALCOHOL 1 LITRE B 0.0073 1000 2024-04-01 2026-03-31 6