Displaying 1 - 3 of 3
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 0314L BACTIGRAS 10CMX10CM (SMN/IMS) CHLORHEXIDINE 10'S A 2.90 10CMX10CM 10 2022-04-06 2024-03-31 Add to Contract as Cat A 6
41 0314L BACTIGRAS 10CMX10CM (SMN) CHLORHEXIDINE 10'S A 3.175 0.5% 10 2024-04-01 2026-03-31 0
40 3203F HEXITANE 5% SOLN (GNT/AHI) CHLORHEXIDINE 4 LITRES B 12.35 5% 0 2022-04-01 2024-03-31 0