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 5281BV APROCIN 0.3% EYE DR (ARP/AHI) CIPROFLOXACIN 10ML BH 8.15 0.3% 0 2022-04-01 2022-09-30 0
41 5281BV APROCIN 0.3% EYE DR (ARP) CIPROFLOXACIN (BH) 10ML BH 8.15 0.3% 0 2024-04-01 2026-03-31 6
41 5282E APROCIN 0.3% OINT (ARP) CIPROFLOXAC (BH) 3G BH 2.6368 0.3% 0 2024-04-01 2026-03-31 0