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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 35462 PEDIA POLY-VITE DROPS (BYP/PHA) MULTIVITAMINS PAEDIATRIC 50ML A 10.79 1 2022-04-01 2024-03-31 6
41 35462 PEDIA POLY-VITE DROPS (BYP) MULTIVITAMINS PAEDIATRIC 50ML A 11.6616 1 2024-04-01 2026-03-31 6