Contracted Products [POLYBAR ACB 100% (EZM/COL) BARIUM SULPHATE]

Contract Number	40
Brand Name	POLYBAR ACB 100% (EZM/COL) BARIUM SULPHATE
Package Size	24X397G
Formulary Category	BQ
Unit Price	52.10
Strength	100%
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	0