Drugs available on Contract - [CYCLOVAX 5% CR (REM) ACYCLOVIR], []

Contract Number	41
Brand Code	56949
Brand Name	CYCLOVAX 5% CR (REM) ACYCLOVIR
Active Ingredient	ACYCLOVIR
Trade Name	CYCLOVAX
Package Size	10G
Formulary Category	A
Pkg Price	3.07
Unit Price	3.0717
Strength	5%
Unit Description	TUBE
Max. Reimbursable Quantity / Month	2
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	TOPICAL
Max Repeats	0
Therapeutic Head	NUCLEOSIDES AND NUCLEOTIDES
Amend Date