Contracted Products [LIFESTYLE MIXED RIDER (ANS) CONDOM]

Contract Number	41
Brand Name	LIFESTYLE MIXED RIDER (ANS) CONDOM
Package Size	3'S
Formulary Category	C
Unit Price	1.0601
Strength
Max. Reimbursable / Month	0
Drug Contract Start Date	2024-04-01
Drug Contract End Date	2024-07-22
Restrict To Ophthalmologist
Restrict To Pulmonologist
Status Description
Max Repeats	0