Displaying 1 - 7 of 7
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 59511 PRED-FORTE 1% EYE DR (ALL/COL) PREDNISOLONE 5ML C 17.67 1% 0 2022-04-01 2024-03-31 0
41 59511 PRED-FORTE 1% EYE DR (ALL) PREDNISOLONE (C) 5ML C 17.6691 1% 1 2024-04-01 2026-03-31 6
42 59511 PRED-FORTE 1% EYE DR (ALL) PREDNISOLONE 5ML C 17.67 1% 1 2026-04-01 No No 6
40 59519 PREDNISOLONE 1% EYE DR (CIR/AHI) 5ML A 6.22 1% 1 2022-04-01 2024-03-31 6
41 5951D PREDNISOLONE 1% EYE DR (FSB) 5ML A 3.9959 1% 1 2024-04-01 2026-03-31 6
42 5951F PREDPLUS 1% EYE DR (SYP) PREDNISOLONE 10ML A 1.98 1% 1 2026-04-01 No No 6
40 59532 MINIMS PREDNISOLONE 0.5% (CHA/STO) 20X0.5ML B 4.74 0.5% 0 2022-04-01 2024-03-31 0