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 67911 PHARIXIA 0.15% RINSE (PMS/COL) BENZYDAMINE 250ML BQ 8.83 0.15% 0 2022-04-01 2024-03-31 0
41 67911 PHARIXIA 0.15% RINSE (PMS) BENZYDAMINE 250ML BQ 13.9994 0.15% 0 2024-04-01 2026-03-31 0