Drugs available on Contract - [ARICEPT 5MG TAB (PFI/STO) DONEPEZIL], []

Contract Number	40
Brand Code	44634
Brand Name	ARICEPT 5MG TAB (PFI/STO) DONEPEZIL
Active Ingredient	DONEPEZIL
Trade Name	ARICEPT
Package Size	28'S
Formulary Category	C
Pkg Price	131.89
Unit Price	4.71
Strength	5MG
Unit Description	TABLET
Max. Reimbursable Quantity / Month	0
Package Description	TAB
Manufacturer Code	PFI
Manufacturer Name	PFIZER CORPORATION
Agent Code	STO
Agent Name	BRYDEN STOKES LTD
Benefit
Benefit Cat Code
Drug Contract Start Date	2022-04-01
Drug Contract End Date	2024-03-31
Restrict To Ophthalmologist
Restrict To Pulmonologist
SIGCode
SIGFactor	28
Dentist Allowed	No
Therapeutic Code	1204
Therapeutic Desc	PARASYMPATHOMIMETIC (CHOLINERGIC) AGENTS
Status Description
Default Route	Oral
Max Repeats	0
Therapeutic Head	AUTONOMIC DRUGS
Amend Date