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 3301AW METHYLPREDNISOLONE 0.1% CR (KWA/ATB) 15G A 6.01 0.1% 2 2022-04-01 2024-03-31 0
40 3301BE ADVANTAN 0.1% CR (LEO/COL) METHYLPREDNISOLONE 15G C 11.50 0.1% 0 2022-04-01 2024-03-31 0
40 3302AA METHYLPREDNISOLONE 0.1% OINT (KWA/ATB) 15G A 6.50 0.1% 2 2022-04-01 2024-03-31 0