Displaying 1 - 2 of 2
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 40517 POENCANIA 0.5% EYE DR (LPO/COL) PROPARACAINE 10ML A 8.43 0.5% 1 2022-04-01 2024-03-31 6
41 4051C P-CAINE 0.5% EYE DR (SHC) PROPARACAINE 5ML A 3.1261 0.5% 1 2024-04-01 2026-03-31 6