Contracted Products [GRAVOL INFANT 25MG SUPPOS (CDC) DIMENHYD]

Contract Number	41
Brand Name	GRAVOL INFANT 25MG SUPPOS (CDC) DIMENHYD
Package Size	10'S
Formulary Category	A
Unit Price	1.0384
Strength	25MG
Max. Reimbursable / Month	10
Drug Contract Start Date	2024-04-01
Drug Contract End Date	2024-12-03
Restrict To Ophthalmologist
Restrict To Pulmonologist
Status Description
Max Repeats	0