Drugs available on Contract - [EUTIROX 125MCG TAB (MEK) THYROXINE], []

Contract Number	41
Brand Code	29961
Brand Name	EUTIROX 125MCG TAB (MEK) THYROXINE
Active Ingredient	THYROXINE
Trade Name	EUTIROX
Package Size	50'S
Formulary Category	A
Pkg Price	20.6049
Unit Price	0.4121
Strength	125MCG
Unit Description	TAB
Max. Reimbursable Quantity / Month	30
Package Description	BOX
Manufacturer Code	MEK
Manufacturer Name	MERCK SERONO
Agent Code	COL
Agent Name	COLLINS 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	683604
Therapeutic Desc	THYROID AGENTS
Status Description
Default Route	ORAL
Max Repeats	6
Therapeutic Head	THYROID AGENTS
Amend Date	2024-05-06