Displaying 1 - 6 of 6
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 2491AD DEXAMETHASONE SODIUM PHOSPHATE 4MG/ML IV/IM INJ (RTM/PHA) 10X1ML B 1.09 4MG/ML IV/IM 0 2022-04-01 2024-03-31 0
41 2491AD DEXAMET. SOD. PHOS. 4MG/ML IV/IM INJ (RTM) 10X1ML BQ 1.4924 4MG/ML IV/IM 0 2024-04-01 2026-03-31 0
42 2491AD DEXAMET. SOD. PHOS. 4MG/ML IV/IM INJ (RTM) 10X1ML B 1.25 4MG/ML IV/IM 0 2026-04-01 No No 0
41 2491AR DEXAMET. SOD. PHOS. 4MG/ML IV/IM INJ (KR (B) 25X1ML B 0.6524 4MG/ML IV/IM 0 2024-04-01 2026-03-31 0
41 24922 DEXAMET. SOD. PHOS. 10MG/ML IV/IM INJ (OMG) DEXAMETHASONE SO (B) 10X1ML B 4.7353 10MG/ML IV/IM 0 2024-04-01 2026-03-31 0
42 24922 DEXAMET. SOD. PHOS. 10MG/ML IV/IM INJ (OMG) DEXAMETHASONE SO 10X1ML B 7.61 10MG/ML IV/IM 0 2026-04-01 No No 0