Contracted Products [MINITRAN 5MG PATCH (PMA/AHI) GLYCERYL TRINITR]

Contract Number	40
Brand Name	MINITRAN 5MG PATCH (PMA/AHI) GLYCERYL TRINITR
Package Size	30'S
Formulary Category	BQ
Unit Price	46.21
Strength	5MG
Max. Reimbursable / Month	0
Drug Contract Start Date	2022-04-01
Drug Contract End Date	2024-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
Status Description
Max Repeats	6