Contracted Products [LEUCOVORIN 50MG INJ (SLS/AHI) ]

Contract Number	40
Brand Name	LEUCOVORIN 50MG INJ (SLS/AHI)
Package Size	5ML
Formulary Category	BQ
Unit Price	12.45
Strength	50MG
Max. Reimbursable / Month	0
Drug Contract Start Date	2022-04-01
Drug Contract End Date	2022-09-30
Restrict To Ophthalmologist
Restrict To Pulmonologist
Status Description
Max Repeats	0