Displaying 1841 - 1860 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 2681A HYDROCORTISONE 10MG TAB (TEV) 30'S A 0.3081 10MG 120 2024-04-01 2024-12-16 6
41 2681A HYDROCORTISONE 10MG TAB (TEV) 30'S A 0.5863 10MG 120 2024-12-17 2026-03-31 6
42 2681B LEECORT 10MG TAB (JLP) HYDROCORTISONE 100'S A 0.16 10MG 120 2026-04-01 No No 6
41 26827 HYDROCORTISONE 20MG TAB (TEV) 30'S A 0.5944 20MG 120 2024-04-01 2024-12-16 6
41 26827 HYDROCORTISONE 20MG TAB (TEV) 30'S A 0.665 20MG 120 2024-12-17 2026-03-31 6
40 2682A HYDROCORTISONE 20MG TAB (SLS/AHI) 50'S A 1.52 20MG 120 2022-04-01 2024-03-31 6
42 2682A HYDROCORTISONE 20MG TAB (SLS) 50'S A 0.87 20MG 120 2026-04-01 No No 6
40 2683AJ HYDROCORTISONE 1% CR (KWA/ATB) 15G A 3.26 1% 2 2022-04-01 2022-09-30 0
41 2683AJ HYDROCORTISONE 1% CR (KWA) 15G A 3.561 1% 2 2024-04-01 2026-03-31 0
41 2683AS MECORT 1% CR (MPI) HYDROCORTISONE 15G A 2.9086 1% 2 2024-04-01 2026-03-31 0
40 2683L HYDROSONE 1% CR (CAR/COL) HYDROCORTISONE 15G A 5.16 1% 2 2022-04-01 2024-03-31 0
41 2683L HYDROSONE 1% CR (CAR) HYDROCORTISONE (C) 15G C 5.5997 1% 2 2024-04-01 2026-03-31 0
42 2683L HYDROSONE 1% CR (CAR) HYDROCORTISONE 15G A 5.60 1% 2 2026-04-01 No No 0
41 26843 HYDROCORTISONE 1% OINT (GPC) 15G A 3.1261 1% 2 2024-04-01 2026-03-31 0
40 26848 HYDROCORTISONE 1% OINT (KWA/ATB) 15G A 3.26 1% 2 2022-04-01 2022-09-30 0
41 26848 HYDROCORTISONE 1% OINT (KWA) 15G A 3.561 1% 2 2024-04-01 2026-03-31 0
40 2684L HYDROSONE 1% OINT (CAR/COL) HYDROCORTISONE 15G A 5.16 1% 2 2022-04-01 2024-03-31 0
42 2684L HYDROSONE 1% OINT (CAR) HYDROCORTISONE 15G A 5.60 1% 2 2026-04-01 No No 0
42 26853 HISONE 5MG TAB (SLS) HYDROCORTISONE 20X10 A 0.19 5MG 120 2026-04-01 No No 6
40 2691AA HYDROCORTISONE SOD SUCC 100MG INJ (CIR/AHI) 100MG VIAL B 1.98 100MG 0 2022-04-01 2024-03-31 0