Drugs available on Contract - [ACYCLOVIR 50MG/ML INJ (KWA) (BQ)], []

Contract Number	41
Brand Code	5691E
Brand Name	ACYCLOVIR 50MG/ML INJ (KWA) (BQ)
Active Ingredient	ACYCLOVIR
Trade Name	ACYCLOVIR
Package Size	10ML VIAL
Formulary Category	BQ
Pkg Price	4.89
Unit Price	4.893
Strength	50MG/ML
Unit Description	VIAL
Max. Reimbursable Quantity / Month	15
Package Description	VIAL
Manufacturer Code	KWA
Manufacturer Name	KWALITY PHARMACEUTICALS
Agent Code	ATB
Agent Name	ANSA TRADING BARBADOS LTD
Benefit
Benefit Cat Code	15
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	081832
Therapeutic Desc	NUCLEOSIDES AND NUCLEOTIDES
Status Description
Default Route	IV
Max Repeats	4
Therapeutic Head	NUCLEOSIDES AND NUCLEOTIDES
Amend Date