Drugs available on Contract - [ZOVIRAX 50MG/ML INJ (GSK) ACYCLOVIR (C)], []

Contract Number	41
Brand Code	5691F
Brand Name	ZOVIRAX 50MG/ML INJ (GSK) ACYCLOVIR (C)
Active Ingredient	ACYCLOVIR
Trade Name	ZOVIRAX
Package Size	5X5ML
Formulary Category	C
Pkg Price	481.63
Unit Price	96.3265
Strength	50MG/ML
Unit Description	VIAL
Max. Reimbursable Quantity / Month	15
Package Description	BOX
Manufacturer Code	GSK
Manufacturer Name	GLAXOSMITHKLINE
Agent Code	COL
Agent Name	COLLINS 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