Contracted Products [AMPHIZOME 50MG INJ (FSB) AMPHOTERICIN B]

Contract Number	42
Brand Name	AMPHIZOME 50MG INJ (FSB) AMPHOTERICIN B
Package Size	5ML
Formulary Category	BQ
Unit Price	12.53
Strength	50MG
Max. Reimbursable / Month	21
Drug Contract Start Date	2026-04-01
Drug Contract End Date
Restrict To Ophthalmologist	No
Restrict To Pulmonologist	No
Status Description	Add to Contract
Max Repeats	0