Drugs available on Contract - [APO-ACYCLOVIR 800MG TAB (APO) ], []

Contract Number	41
Brand Code	5698P
Brand Name	APO-ACYCLOVIR 800MG TAB (APO)
Active Ingredient	ACYCLOVIR
Trade Name	APO-ACYCLOVIR
Package Size	100'S
Formulary Category	A
Pkg Price	39.55
Unit Price	0.3955
Strength	800MG
Unit Description	TAB
Max. Reimbursable Quantity / Month	50
Package Description	BOTT
Manufacturer Code	APO
Manufacturer Name	APOTEX INC.
Agent Code	ATB
Agent Name	ANSA TRADING BARBADOS 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	100
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