Displaying 2201 - 2220 of 5993
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
42 3301AJ FURASONE 0.1% CR (CAR) MOMETASONE 15G A 6.20 0.1% 2 2026-04-01 No No 0
40 3301AW METHYLPREDNISOLONE 0.1% CR (KWA/ATB) 15G A 6.01 0.1% 2 2022-04-01 2024-03-31 0
40 3301AX MOMETASONE 0.1% CR (KWA/ATB) 15G A 4.49 0.1% 2 2022-04-01 2024-03-31 0
40 3301BC ELOCOM 0.1% CR (MSD/STO) MOMETASONE 15G C 10.11 0.1% 0 2022-04-01 2024-03-31 0
41 3301BC ELOCOM 0.1% CR (MSD) MOMETASONE 15G A 10.22 0.1% 2 2024-04-01 2024-07-18 0
41 3301BC ELOCOM 0.1% CR (MSD) MOMETASONE (C) 15G C 10.2209 0.1% 2 2024-07-19 2026-03-31 0
42 3301BC ELOCON 0.1% CR (MSD) MOMETASONE 15G C 10.22 0.1% 2 2026-04-01 No No 0
40 3301BE ADVANTAN 0.1% CR (LEO/COL) METHYLPREDNISOLONE 15G C 11.50 0.1% 0 2022-04-01 2024-03-31 0
42 3301BJ FLUTICA 0.05% CR (ARP) 10G A 3.26 0.05% 2 2026-04-01 No No 0
41 3301BK TROSONE 0.1% CR (AUR) MOMETASONE 15G A 5.0561 0.1% 2 2024-04-01 2026-03-31 0
40 3302AA METHYLPREDNISOLONE 0.1% OINT (KWA/ATB) 15G A 6.50 0.1% 2 2022-04-01 2024-03-31 0
40 3302BC ELOCON 0.1% OINT (MSD/STO) MOMETASONE 15G C 11.93 0.1% 0 2022-04-01 2024-03-31 0
41 3302BC ELOCON 0.1% OINT (MSD) MOMETASONE 15G A 12.0422 0.1% 2 2024-04-01 2024-07-18 0
41 3302BC ELOCON 0.1% OINT (MSD) MOMETASONE (C) 15G C 12.04 0.1% 2 2024-07-19 2026-03-31 0
42 3302BC ELOCON 0.1% OINT (MSD) MOMETASONE 15G C 12.04 0.1% 2 2026-04-01 2028-03-31 No No 0
40 3302Z FURASONE 0.1% OINT (CAR/COL) MOMETASONE 15G A 5.16 0.1% 2 2022-04-01 2024-03-31 0
41 3302Z FURASONE 0.1% OINT (CAR) MOMETASONE 15G A 6.1978 0.1% 2 2024-04-01 2026-03-31 0
42 3302Z FURASONE 0.1% OINT (CAR) MOMETASONE 15G A 6.20 0.1% 2 2026-04-01 No No 0
41 33624 COLCHICINE 0.5MG TAB (CAM) 100'S A 0.1563 0.5MG 90 2024-04-01 2026-03-31 6
40 33625 COLCHICINE 0.5MG TAB (CAM/AHI) 100'S A 0.27 0.5MG 90 2022-04-01 2024-03-31 6