Contracted Products [PROCTO-GLYVENOL 40MG | 400MG SUPPOS (GSK/COL) LIDOCAINE

Contracted Products [PROCTO-GLYVENOL 40MG | 400MG SUPPOS (GSK/COL) LIDOCAINE | TRIBENOSIDE]

Contract Number	40
Brand Name	PROCTO-GLYVENOL 40MG \| 400MG SUPPOS (GSK/COL) LIDOCAINE \| TRIBENOSIDE
Package Size	5'S
Formulary Category	A
Unit Price	0.95
Strength	40MG\|400MG
Max. Reimbursable / Month	5
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