Contracted Products [ACUCLAV 500MG/125MG TAB (MCP/AHI)]

Contract Number	40
Brand Name	ACUCLAV 500MG/125MG TAB (MCP/AHI)
Package Size	20's
Formulary Category	B
Unit Price	$0.177
Strength	500MG / 125MG
Max. Reimbursable / Month	21
Drug Contract Start Date	2023-06-06
Drug Contract End Date	2024-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
Status Description	B
Max Repeats