Drugs available on Contract - [COTRIMOXAZOLE 400MG|80MG TAB (HEA) SULFAMETHOXAZOLE|TRIMETHO], []

Contract Number	42
Brand Code	0451BZ
Brand Name	COTRIMOXAZOLE 400MG\|80MG TAB (HEA) SULFAMETHOXAZOLE\|TRIMETHO
Active Ingredient	SULFAMETHOXAZOLE\|TRIMETHOPRIM
Trade Name	COTRIMOXAZOLE
Package Size	10X10
Formulary Category	A
Pkg Price	7.12
Unit Price	0.07
Strength	400MG\|80MG
Unit Description	TAB
Max. Reimbursable Quantity / Month	56
Package Description	BLIS
Manufacturer Code	HEA
Manufacturer Name	HEALTH 2000 INC
Agent Code	AHI
Agent Name	ARMSTRONG HEALTHCARE INC
Benefit
Benefit Cat Code
Drug Contract Start Date	2026-04-01
Drug Contract End Date
Restrict To Ophthalmologist	No
Restrict To Pulmonologist	No
SIGCode
SIGFactor	0
Dentist Allowed	N
Therapeutic Code	081220
Therapeutic Desc	SULPHONAMIDES
Status Description	Price Change
Default Route	ORAL
Max Repeats	0
Therapeutic Head	SULPHONAMIDES
Amend Date	2025-10-31