Drugs available on Contract - [LIPITOR 20MG TAB (PFI) ATORVASTATIN (C)], []

Contract Number	41
Brand Code	1132DV
Brand Name	LIPITOR 20MG TAB (PFI) ATORVASTATIN (C)
Active Ingredient	ATORVASTATIN
Trade Name	LIPITOR
Package Size	30'S
Formulary Category	C
Pkg Price	36.53
Unit Price	1.2178
Strength	20MG
Unit Description	TAB
Max. Reimbursable Quantity / Month	30
Package Description	BOX
Manufacturer Code	PFI
Manufacturer Name	PFIZER CORPORATION
Agent Code	STO
Agent Name	BRYDEN STOKES LTD
Benefit
Benefit Cat Code	18
Drug Contract Start Date	2024-04-01
Drug Contract End Date	2026-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
SIGCode	1TOD
SIGFactor	1
Dentist Allowed	N
Therapeutic Code	240608
Therapeutic Desc	HMG-CoA REDUCTASE INHIBITORS
Status Description
Default Route	ORAL
Max Repeats	6
Therapeutic Head	HMG-CoA REDUCTASE INHIBITORS
Amend Date