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 9991BS UREA | GLYCERINE 10% | 5% CR (CAR/COL) 100G B 0.14 10%|5% 0 2022-04-01 2024-03-31 0
41 9991BS UREA|GLYCERINE 10%|5% CR (CAR) (B) 100G B 0.1495 10%|5% 2 2024-04-01 2026-03-31 6
40 9991BT UREA | GLYCERINE 5% | 10% CR (CAR/COL) 100G B 0.12 5%|10% 0 2022-04-01 2024-03-31 0
41 9991BT UREA|GLYCERINE 5%|10% CR (CAR) (B) 100G B 0.1223 5%|10% 2 2024-04-01 2026-03-31 6