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 2721C TRIAM-DENK 40MG/ML INJ (EDK/COL) TRIAMCINOLON 10X1ML B 2.79 40MG/ML 0 2022-04-01 2024-03-31 0
41 2721C TRIAM-DENK 40MG/ML INJ (EDK) TRIAMCINOLO (B) 10X1ML B 3.088 40MG/ML 4 2024-04-01 2026-03-31 6
40 2721N TRIAMCINOLONE 40MG/ML INJ (CIR/AHI) 1ML VIAL B 2.99 40MG/ML 0 2022-04-01 2024-03-31 0
41 2721N TRIAMCINOLONE 40MG/ML INJ (CIR) (B) 1ML VIAL B 3.2892 40MG/ML 4 2024-04-01 2026-03-31 6