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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
40 0012AN MEQUILAN 5MG TAB (CAR/COL) MEQUITAZINE 112'S A 0.38 5MG 28 2022-04-01 2024-03-31 0