Displaying 1 - 9 of 9
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 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 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