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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
42 1151B TRILIPIX 135MG DR CAP (ABB) FENOFIBRATE 3X10 C 2.99 135MG 0 2026-04-01 No No 0