Displaying 1 - 2 of 2
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 42536 BNT 500U | 3MG | 2MG OINT (CAR/COL) BACITRACIN | NE 15G A 8.26 500U/G|3MG/G|2MG/G 2 2022-04-01 2024-03-31 0
41 42536 BNT 500U|3MG|2MG OINT (CAR) BACITRACIN|N 15G A 8.4812 500U/G|3MG/G|2MG/G 2 2024-04-01 2026-03-31 0