Drugs available on Contract - [CYCLOVAX 200MG TAB (REM) ACYCLOVIR (C)], []

Contract Number	41
Brand Code	5693CG
Brand Name	CYCLOVAX 200MG TAB (REM) ACYCLOVIR (C)
Active Ingredient	ACYCLOVIR
Trade Name	CYCLOVAX
Package Size	3X10
Formulary Category	C
Pkg Price	4.49
Unit Price	0.1495
Strength	200MG
Unit Description	TAB
Max. Reimbursable Quantity / Month	50
Package Description	BOX
Manufacturer Code	REM
Manufacturer Name	REMEDICA LTD
Agent Code	SBI
Agent Name	MASSY DISTRIBUTION (BDOS) 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	081832
Therapeutic Desc	NUCLEOSIDES AND NUCLEOTIDES
Status Description
Default Route	ORAL
Max Repeats	0
Therapeutic Head	NUCLEOSIDES AND NUCLEOTIDES
Amend Date