Drugs available on Contract - [LIFESTYLE MIXED RIDER (ANS) CONDOM], []

Contract Number	41
Brand Code	5201GL
Brand Name	LIFESTYLE MIXED RIDER (ANS) CONDOM
Active Ingredient	CONDOM
Trade Name	LIFESTYLE MIXED RIDER
Package Size	3'S
Formulary Category	C
Pkg Price	1.0601
Unit Price	1.0601
Strength
Unit Description	PACK
Max. Reimbursable Quantity / Month	0
Package Description
Manufacturer Code	ANS
Manufacturer Name	ANSELL HEALTHCARE
Agent Code	SBI
Agent Name	MASSY DISTRIBUTION (BDOS) LTD
Benefit
Benefit Cat Code
Drug Contract Start Date	2024-04-01
Drug Contract End Date	2024-07-22
Restrict To Ophthalmologist
Restrict To Pulmonologist
SIGCode
SIGFactor	0
Dentist Allowed	N
Therapeutic Code	6813
Therapeutic Desc	CONDOMS
Status Description
Default Route	N/A
Max Repeats	0
Therapeutic Head	CONDOMS
Amend Date	2024-07-22