Displaying 1 - 5 of 5
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 40418 B.S.S. SOLN (ALC/AHI) BALANCED SALT 15ML BQ 12.67 0 2022-04-01 2024-03-31 0
41 40418 B.S.S. SOLN (ALC) BALANCED SALT (BQ) 15ML BQ 12.9936 10 2024-04-01 2026-03-31 0
40 40439 B.S.S. PLUS SOLN (ALC/AHI) BALANCED SALT SOL 500ML BQ 32.48 0 2022-04-01 2024-03-31 0
40 4043A B.S.S (BAG) SOLN (ALC/AHI) BALANCED SALT 500ML BQ 29.33 0 2022-04-01 2024-03-31 0
41 4043A B.S.S (BAG) SOLN (ALC) BALANCED SALT (BQ) 500ML BQ 29.9016 10 2024-04-01 2026-03-31 0