Drugs available on Contract - [TRIVASTAL RETARD 50MG TAB (SER) PIRIBEDIL (C)], []

Contract Number	41
Brand Code	5242H
Brand Name	TRIVASTAL RETARD 50MG TAB (SER) PIRIBEDIL (C)
Active Ingredient	PIRIBEDIL
Trade Name	TRIVASTAL RETARD
Package Size	30'S
Formulary Category	C
Pkg Price	26.34
Unit Price	0.878
Strength	50MG
Unit Description	TAB
Max. Reimbursable Quantity / Month	30
Package Description	BOX
Manufacturer Code	SER
Manufacturer Name	LES LABORATOIRES SERVIER
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	1216
Therapeutic Desc	SYMPATHOLYTIC (ADRENERGIC BLOCKING) AGENTS
Status Description
Default Route	ORAL
Max Repeats	60
Therapeutic Head	SYMPATHOLYTIC (ADRENERGIC BLOCKING) AGENTS
Amend Date