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 3301AD CUTIVATE 0.05% CR (GSK/COL) FLUTICASONE 15G C 11.15 0.05% 0 2022-04-01 2024-03-31 0
42 3301AD CUTIVATE 0.05% CR (GSK) FLUTICASONE 15G C 13.48 0.05% 2 2026-04-01 No No 0
42 3301BJ FLUTICA 0.05% CR (ARP) 10G A 3.26 0.05% 2 2026-04-01 No No 0