Contracted Products [TRIVERAM 5MG|10MG|5MG TAB (SER) AM (C)]

Contract Number	42
Brand Name	TRIVERAM 5MG\|10MG\|5MG TAB (SER) AM (C)
Package Size	30'S
Formulary Category	C
Unit Price	2.03
Strength	5MG\|10MG\|5MG
Max. Reimbursable / Month
Drug Contract Start Date	2026-04-01
Drug Contract End Date
Restrict To Ophthalmologist	No
Restrict To Pulmonologist	No
Status Description	Add to Contract as Cat C
Max Repeats