Drugs available on Contract - [CANESTEN-3 200MG VAG PESS (BSP) CLOTRIMAZOLE], []

Contract Number	41
Brand Code	55618
Brand Name	CANESTEN-3 200MG VAG PESS (BSP) CLOTRIMAZOLE
Active Ingredient	CLOTRIMAZOLE
Trade Name	CANESTEN-3
Package Size	3'S
Formulary Category	A
Pkg Price	9.19
Unit Price	9.1879
Strength	200MG
Unit Description	PACK
Max. Reimbursable Quantity / Month	1
Package Description	BOX
Manufacturer Code	BSP
Manufacturer Name	BAYER SCHERING PHARMA AG.
Agent Code	AHI
Agent Name	ARMSTRONG HEALTHCARE INC
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	1
Dentist Allowed	N
Therapeutic Code	081408
Therapeutic Desc	AZOLES
Status Description
Default Route	VAGINAL
Max Repeats	0
Therapeutic Head	AZOLES
Amend Date