Displaying 1 - 11 of 11
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 01243 OPTOMYCIN 0.5% EYE DR (ASL/PHA) CHLORAMPHENIC 10ML C 4.08 0.5% 0 2022-04-01 2024-03-31 0
40 0124N CHLORAMPHENICOL 0.5% EYE DR (MTP/COL) 10ML C 2.58 0.5% 0 2022-04-01 2024-03-31 0
40 0124R CHLORAMPHENICOL 0.5% EYE DR (CIR/AHI) 10ML A 1.90 0.5% 1 2022-04-01 2024-03-31 0
41 0124R CHLORAMPHENICOL 0.5% EYE DR (CIR) 10ML A 2.0659 0.5% 1 2024-04-01 2026-03-31 0
40 0124V CHLORAMPHENICOL 0.5% EYE DR (FSB/ATB) 10ML A 1.60 0.5% 1 2022-04-01 2024-03-31 0
41 0124V CHLORAMPHENICOL 0.5% EYE DR (FSB) 10ML A 1.6582 0.5% 1 2024-04-01 2026-03-31 0
41 0124Y OPTICHLOR 0.5% EYE DR (SHC) CHLORAMPHENICOL 10ML A 2.6096 0.5% 1 2024-04-01 2024-08-01 0
40 0125J CHLORAMPHENICOL 1% EYE OINT (MTP/COL) 4G A 4.21 1% 1 2022-04-01 2024-03-31 0
40 0125M OPTICHLOR SL 1% EYE OINTMENT 5G A 1% 1 2023-06-01 2024-03-31 0
41 0125M OPTICHLOR SL 1% EYE OINT (SPC) CHLORAMPHENICOL 5G A 3.262 1% 1 2024-04-01 2026-03-31 0
40 01261 CHLORAMPHENICOL MINIMS 0.5% EYE DR (CAM/STO) 20X0.5ML BQ 4.74 0.5% 0 2022-04-01 2024-03-31 6