Drugs available on Contract - [METFORMIN XR], []

Contract Number	40
Brand Code	2841BX
Brand Name	METFORMIN XR
Active Ingredient	METFORMIN XR
Trade Name	METFORMIN XR
Package Size	100'S
Formulary Category	A
Pkg Price	7.48
Unit Price	.0748
Strength	500MG
Unit Description	TAB
Max. Reimbursable Quantity / Month	120
Package Description	BOX
Manufacturer Code	HEA
Manufacturer Name	HEALTH 2000
Agent Code	ATB
Agent Name	ANSA TRADING
Benefit	B
Benefit Cat Code
Drug Contract Start Date	2022-12-07
Drug Contract End Date	2024-03-31
Restrict To Ophthalmologist	No
Restrict To Pulmonologist	No
SIGCode	1TBD
SIGFactor	2
Dentist Allowed	N
Therapeutic Code	682004
Therapeutic Desc	BIGUANIDES
Status Description	ADD AS CAT A BENEFIT
Default Route	ORAL
Max Repeats	6
Therapeutic Head
Amend Date	2022-12-07