Displaying 1 - 4 of 4
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 2701B DEPO-MEDROL 40MG/ML INJ (PFI/STO) METHYLPREDN 1ML VIAL C 14.79 40MG/ML 0 2022-04-01 2024-03-31 0
41 2701B DEPO-MEDROL 40MG/ML INJ (PFI) METHYLPRED (C) 1ML VIAL C 14.9236 40MG/ML 0 2024-04-01 2026-03-31 0
40 2701C METHYLPREDNISOLONE 40MG/ML INJ (MON/PHA) 2ML VIAL B 3.91 40MG/ML 0 2022-04-01 2024-03-31 0
41 2701C METHYLPREDNISOLONE 40MG/ML INJ (MON (B) 2ML VIAL B 4.29 40MG/ML 0 2024-04-01 2026-03-31 0