Contracted Products [ETHINYL ESTRADIOL|LEVONORGESTREL 30MCG|150MCG TAB (APO) (C)]

Contract Number	41
Brand Name	ETHINYL ESTRADIOL\|LEVONORGESTREL 30MCG\|150MCG TAB (APO) (C)
Package Size	28'S
Formulary Category	C
Unit Price	0.1631
Strength	30MCG\|150MCG
Max. Reimbursable / Month	0
Drug Contract Start Date	2024-04-01
Drug Contract End Date	2026-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
Status Description
Max Repeats	0