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
41 4631AA LUBRICATING JELLY (CHC) (B) 120G B 4.8658 0 2024-04-01 2026-03-31 0
41 4631AB LUBRICATING JELLY (KWA) (B) 120G B 5.5454 1% 0 2024-04-01 2026-03-31 0
40 4631N DESIRE JELLY (HEA/ATB) LUBRICATING JELLY(B) 82G B 3.26 2022-12-07 2024-03-31 No No Change Local Agent 0
41 4631N DESIRE JELLY (HEA) LUBRICATING JELLY (B) 82G B 3.3164 0 2024-04-01 2026-03-31 0