Displaying 1 - 4 of 4
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 52816 FUCITHALMIC 1% EYE DR (ANT/COL) FUSIDIC ACID 5G A 14.95 1% 1 2022-04-01 2024-03-31 0
42 52816 FUCITHALMIC 1% EYE DR (ANT) FUSIDIC ACID 5G A 8.83 1% 1 2026-04-01 No No 0
41 5281BW FUSITHAL 1% EYE DR (ARP) FUSIDIC ACID 5G A 10.5743 1% 1 2024-04-01 2026-03-31 0
42 5281BW FUSITHAL 1% EYE DR (ARP) FUSIDIC ACID 5G A 10.57 1% 1 2026-04-01 No No 0