Displaying 1 - 2 of 2
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 79913 BEROTEC N 100MCG INHR (BOE/AHI) FENOTEROL 200 DOSES A 31.80 100MCG 1 2022-04-01 2024-03-31 6
41 79913 BEROTEC N 100MCG INHR (BOE) FENOTEROL 200 DOSES A 33.3 100MCG 1 2024-11-11 2026-03-31 6