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 1201P AZARGA 1% | 0.5% EYE DR (NVS/COL) BRINZOLAMIDE | 5ML C 19.79 1%|0.5% 0 2022-04-01 2024-03-31 0
41 1201P AZARGA 1%|0.5% EYE DR (NVS) BRINZOLAMIDE|TIMOLOL (BQ) 5ML BQ 19.7894 1%|0.5% 1 2024-04-01 2026-03-31 6