Contracted Products [NITRODERM TTS 5 25MG PATCH (BCH/COL) GLYCERYL]

Contract Number	40
Brand Name	NITRODERM TTS 5 25MG PATCH (BCH/COL) GLYCERYL
Package Size	10'S
Formulary Category	BQ
Unit Price	19.68
Strength	25MG
Max. Reimbursable / Month	0
Drug Contract Start Date	2022-04-01
Drug Contract End Date	2022-05-24
Restrict To Ophthalmologist
Restrict To Pulmonologist
Status Description	Delete from contract
Max Repeats	0