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 0884BL IPRAVENT 0.25MG/ML RESP SOL (CIP/AHI) IPRATRO 20X2ML A 1.64 0.25MG/ML 1 2022-04-01 2024-03-31 6
40 0884BT IPRAVENT 0.25MG/ML RESP SOL (CIP/AHI) IPRATRO 15ML A 1.82 0.25MG/ML 1 2022-04-01 2024-03-31 6