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 40311 GLYCINE (2B7317) 1.5% INJ (BAX/STO) 3 LITRES BQ 13.86 1.5% 0 2022-04-01 2024-03-31 0
41 40311 GLYCINE (2B7317) 1.5% INJ (BAX) (BQ) 3 LITRES BQ 26.2046 1.5% 0 2024-04-01 2026-03-31 0
40 40313 GLYCINE 1.5% INJ (BRA/COL) 3 LITRES BQ 14.92 1.5% 0 2022-04-01 2024-03-31 0
41 40313 GLYCINE 1.5% INJ (BRA) (BQ) 3 LITRES BQ 46.8911 1.5% 0 2024-04-01 2026-03-31 0