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	1.24
Strength
Max. Reimbursable / Month	0
Drug Contract Start Date	2024-07-23
Drug Contract End Date	2026-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
Status Description
Max Repeats	0