Displaying 1 - 3 of 3
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
40 4211W MICOSPEC BV 0.1% | 2% CR (CAR/COL) BETAMETHASONE | MICONAZOLE 15G A 3.81 0.1%/G|2%/G 2 2022-04-01 2024-03-31 0
41 4211W MICOSPEC BV 0.1%|2% CR (CAR) BETAMETHASONE|MICONAZOLE 15G A 3.9959 0.1%|2% 2 2024-04-01 2026-03-31 0
42 4211W MICOSPEC BV 0.1%|2% CR (CAR) BETAMETHASONE|MICONAZOLE 15G A 4.00 0.1%|2% 2 2026-04-01 No No 0