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 20821 BEZIDE HS 2.5MG TAB (CAR/COL) BENDROFLUAZIDE 500'S A 0.03 2.5MG 30 2022-04-01 2024-03-31 6
41 20821 BEZIDE HS 2.5MG TAB (CAR) BENDROFLUAZIDE 500'S A 0.0326 2.5MG 30 2024-04-01 2026-03-31 6