Contracted Products [ENEMA-LAX ADULT 7G | 19G ENEMA (LAF/AHI) SODIUM BIPHOSPHATE

Contracted Products [ENEMA-LAX ADULT 7G | 19G ENEMA (LAF/AHI) SODIUM BIPHOSPHATE | SODIUM PHOSPHATE]

Contract Number	40
Brand Name	ENEMA-LAX ADULT 7G \| 19G ENEMA (LAF/AHI) SODIUM BIPHOSPHATE \| SODIUM PHOSPHATE
Package Size	133ML
Formulary Category	A
Unit Price	3.89
Strength	7G\|19G
Max. Reimbursable / Month	2
Drug Contract Start Date	2022-04-01
Drug Contract End Date	2024-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
Status Description	Change Local Agent
Max Repeats	6