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 2371H OXOZOLIN 0.05% NASAL DR (ARP/AHI) OXYMETAZOLI 10ML A 4.57 0.05% 1 2022-04-01 2024-03-31 0
41 2371H OXOZOLIN 0.05% NASAL DR (ARP) OXYME 10ML A 4.9473 0.05% 1 2024-04-01 2026-03-31 0
41 2371M AFRIN 0.05% NASAL DR (BSP) OXYMETAZOLINE (C) 15ML C 13.4557 0.05% 1 2024-04-01 2026-03-31 0
40 2373G OXOZOLIN PAED 0.025% NASAL DR (ARP/AHI) OXYME 10ML A 4.05 0.025% 1 2022-04-01 2024-03-31 0