Drugs available on Contract - [ALDACTONE 25MG TAB (PFI) SPIRONOLACTONE (C)], []

Contract Number	41
Brand Code	21411
Brand Name	ALDACTONE 25MG TAB (PFI) SPIRONOLACTONE (C)
Active Ingredient	SPIRONOLACTONE
Trade Name	ALDACTONE
Package Size	100'S
Formulary Category	C
Pkg Price	53.52
Unit Price	0.5352
Strength	25MG
Unit Description	TAB
Max. Reimbursable Quantity / Month	120
Package Description	BOX
Manufacturer Code	PFI
Manufacturer Name	PFIZER CORPORATION
Agent Code	STO
Agent Name	BRYDEN STOKES LTD
Benefit
Benefit Cat Code
Drug Contract Start Date	2024-04-01
Drug Contract End Date	2026-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
SIGCode
SIGFactor	0
Dentist Allowed	N
Therapeutic Code	243220
Therapeutic Desc	ALDOSTERONE RECEPTOR ANTAGONIST
Status Description
Default Route	ORAL
Max Repeats	6
Therapeutic Head	ALDOSTERONE RECEPTOR ANTAGONIST
Amend Date