Displaying 1 - 3 of 3
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 A7017 PILOCARPINE | TIMOLOL 2% | 0.5% EYE DR (FSB/ATB) 5ML A 5.76 2%|0.5% 1 2022-04-01 2024-03-31 Price Change 6
42 A7019 PILOCARPINE|TIMOLOL 2%|0.5% EYE DR (CHC) 5ML A 19.52 2%|0.5% 1 2026-04-01 No No Add to Contract as Cat A 6
40 A7026 PILOCARPINE | TIMOLOL 4% | 0.5% EYE DR (FSB/ATB) 5ML A 7.04 4%|0.5% 1 2022-04-01 2024-03-31 Price Change 6