Displaying 1 - 8 of 8
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 21431 INSPRA 50MG TAB (PFI/STO) EPLERENONE 30'S B 3.26 50MG 60 2022-04-01 2024-03-31 6
41 21431 INSPRA 50MG TAB (PFI) EPLERENONE (C) 30'S C 3.349 50MG 60 2024-04-01 2026-03-31 6
40 21432 INSPRA 25MG TAB (PFI/STO) EPLERENONE 30'S B 2.96 25MG 60 2022-04-01 2024-03-31 6
41 21432 INSPRA 25MG TAB (PFI) EPLERENONE (C) 30'S C 3.0436 25MG 60 2024-04-01 2026-03-31 6
41 21433 INSPRA 50MG TAB (PFI) EPLERENONE (C) 30'S C 3.349 50MG 60 2024-04-01 2026-03-31 6
41 21434 INSPRA 25MG TAB (PFI) EPLERENONE (C) 30'S C 3.0436 25MG 60 2024-04-01 2026-03-31 6
41 21435 EPNONE 50MG TAB (MSN) EPLERENONE (B) 30'S B 0.7131 50MG 60 2024-04-01 2026-03-31 6
41 21436 EPNONE 25MG TAB (MSN) EPLERENONE (B) 30'S B 0.4213 25MG 60 2024-04-01 2026-03-31 6