Contracted Products [ACRYLARM 0.2% GEL (LPO/COL) POLYACRYLIC ACID]

Contract Number	40
Brand Name	ACRYLARM 0.2% GEL (LPO/COL) POLYACRYLIC ACID
Package Size	10G
Formulary Category	B
Unit Price	11.15
Strength	0.2%
Max. Reimbursable / Month	1
Drug Contract Start Date	2022-04-01
Drug Contract End Date	2024-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
Status Description
Max Repeats	6