Drugs available on Contract - [TROSONE 0.1% CR (AUR) MOMETASONE], []

Contract Number	41
Brand Code	3301BK
Brand Name	TROSONE 0.1% CR (AUR) MOMETASONE
Active Ingredient	MOMETASONE
Trade Name	TROSONE
Package Size	15G
Formulary Category	A
Pkg Price	5.0561
Unit Price	5.0561
Strength	0.1%
Unit Description	TUBE
Max. Reimbursable Quantity / Month	2
Package Description	TUBE
Manufacturer Code	AUR
Manufacturer Name	AUROCHEM LABORATORIES
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	8406
Therapeutic Desc	ANTI-INFLAMMATORY AGENTS, TOPICAL
Status Description
Default Route	TOPICAL
Max Repeats	0
Therapeutic Head	ANTI-INFLAMMATORY AGENTS, TOPICAL
Amend Date