Contracted Products [LIFESTYLES ULTRA THIN (ANS/SBI) CONDOM]

Contract Number	40
Brand Name	LIFESTYLES ULTRA THIN (ANS/SBI) CONDOM
Package Size	3'S
Formulary Category	C
Unit Price	1.92
Strength
Max. Reimbursable / Month	0
Drug Contract Start Date	2022-06-14
Drug Contract End Date	2024-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
Status Description	Price Change
Max Repeats	0