Drugs available on Contract - [ACETAZOLAMIDE 250MG TAB (REM)], []

Contract Number	41
Brand Code	22814
Brand Name	ACETAZOLAMIDE 250MG TAB (REM)
Active Ingredient	ACETAZOLAMIDE
Trade Name	ACETAZOLAMIDE
Package Size	1000'S
Formulary Category	A
Pkg Price	107.4
Unit Price	0.1074
Strength	250MG
Unit Description	TAB
Max. Reimbursable Quantity / Month	120
Package Description	BOTT
Manufacturer Code	REM
Manufacturer Name	REMEDICA LTD
Agent Code	SBI
Agent Name	MASSY DISTRIBUTION (BDOS) LTD
Benefit	B
Benefit Cat Code	Anti-Glaucoma
Drug Contract Start Date	2024-04-01
Drug Contract End Date	2026-03-31
Restrict To Ophthalmologist	Yes
Restrict To Pulmonologist
SIGCode
SIGFactor	0
Dentist Allowed	N
Therapeutic Code	402804
Therapeutic Desc	CARBONIC ANHYDRASE INHIBITORS
Status Description
Default Route	ORAL
Max Repeats	6
Therapeutic Head	CARBONIC ANHYDRASE INHIBITORS
Amend Date