Displaying 1821 - 1840 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
41 26517 BETAMETHASONE 0.5MG TAB (LAF) 100'S A 0.6116 0.5MG 240 2024-04-01 2026-03-31 6
42 26517 BETAMETHASONE 0.5MG TAB (LAF) 100'S A 0.47 0.5MG 240 2026-04-01 No No 6
40 26613 PMS-DEXAMETHASONE 0.5MG TAB (PMS/COL) 100'S A 0.08 0.5MG 90 2022-04-01 2024-03-31 6
40 26614 APO-DEXAMETHASONE 0.5MG TAB (APO/COL) 100'S A 0.08 0.5MG 90 2022-04-01 2024-03-31 6
42 26614 APO-DEXAMETHASONE 0.5MG TAB (APO) 100'S A 0.08 0.5MG 90 2026-04-01 No No 6
41 2661S APO-DEXAMETHASONE 0.5MG TAB (APO) 100'S A 0.0859 0.5MG 90 2024-04-01 2026-03-31 6
40 2662E SONEXA 0.1% EYE DR (ARP/AHI) DEXAMETHASONE 5ML B 4.57 0.1% 0 2022-04-01 2024-03-31 6
42 2662E SONEXA 0.1% EYE DR (ARP) DEXAMETHAS 5ML B 4.05 0.1% 1 2026-04-01 No No 6
41 2662F MONODEXA 0.1% EYE DR (SHC) DEXAMETHASONE (B) 5ML B 4.0775 0.1% 1 2024-04-01 2026-03-31 6
42 2662F MONODEXA 0.1% EYE DR (SHC) DEXAMETHASONE 5ML B 4.08 0.1% 1 2026-04-01 No No 6
40 26636 APO-DEXAMETHASONE 4MG TAB (APO/COL) 100'S A 0.21 4MG 90 2022-04-01 2024-03-31 6
42 26636 APO-DEXAMETHASONE 4MG TAB (APO) 100'S A 0.21 4MG 90 2026-04-01 No No 6
42 26637 PMS-DEXAMETHASONE 4MG TAB (PMS) 100'S A 0.16 4MG 90 2026-04-01 2028-03-31 No No 6
41 2663B DARDEX 4MG TAB (MBL) DEXAMETHASONE 30'S A 0.2111 4MG 90 2024-04-01 2026-03-31 6
41 2663C APO-DEXAMETHASONE 4MG TAB (APO) 100'S A 0.2164 4MG 90 2024-04-01 2026-03-31 6
40 26719 FLUDROCORTISONE 0.1MG TAB (SLS/AHI) 200'S A 0.81 0.1MG 60 2022-04-01 2024-03-31 6
41 2671A FLUDROCORTISONE 0.1MG TAB (SLS) 200'S A 0.8372 0.1MG 60 2024-04-01 2026-03-31 6
42 2671A FLUDROCORTISONE 0.1MG TAB (SLS) 200'S A 0.84 0.1MG 60 2026-04-01 No No 6
40 26818 HYDROCORTISONE 10MG TAB (SLS/AHI) 200'S A 0.75 10MG 120 2022-04-01 2024-03-31 6
42 26818 HYDROCORTISONE 10MG TAB (SLS) 200'S A 0.29 10MG 120 2026-04-01 No No 6