Contracted Products [ISENTRESS 400MG TAB (MSD) RALTEGRAVIR (BL)]

Contract Number	41
Brand Name	ISENTRESS 400MG TAB (MSD) RALTEGRAVIR (BL)
Package Size	60'S
Formulary Category	BL
Unit Price	15.2946
Strength	400MG
Max. Reimbursable / Month	120
Drug Contract Start Date	2024-04-01
Drug Contract End Date	2026-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
Status Description
Max Repeats	6