Drugs available on Contract - [DARDEX 4MG TAB (MBL) DEXAMETHASONE], []

Contract Number	41
Brand Code	2663B
Brand Name	DARDEX 4MG TAB (MBL) DEXAMETHASONE
Active Ingredient	DEXAMETHASONE
Trade Name	DARDEX
Package Size	30'S
Formulary Category	A
Pkg Price	6.33
Unit Price	0.2111
Strength	4MG
Unit Description	TAB
Max. Reimbursable Quantity / Month	90
Package Description	BOX
Manufacturer Code	MBL
Manufacturer Name	MEDICAMEN BIOTECH LTD
Agent Code	AHI
Agent Name	ARMSTRONG HEALTHCARE INC
Benefit
Benefit Cat Code
Drug Contract Start Date	2024-04-01
Drug Contract End Date	2026-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
SIGCode
SIGFactor	0
Dentist Allowed	N
Therapeutic Code	6804
Therapeutic Desc	ADRENALS
Status Description
Default Route	ORAL
Max Repeats	6
Therapeutic Head	ADRENALS
Amend Date