Drugs available on Contract - [AZOPT 1% EYE DR (NVS) BRINZOLAMIDE], []

Contract Number	41
Brand Code	A371R
Brand Name	AZOPT 1% EYE DR (NVS) BRINZOLAMIDE
Active Ingredient	BRINZOLAMIDE
Trade Name	AZOPT
Package Size	10ML
Formulary Category	A
Pkg Price	29.22
Unit Price	29.222
Strength	1%
Unit Description	BOTT
Max. Reimbursable Quantity / Month	1
Package Description	BOTT
Manufacturer Code	NVS
Manufacturer Name	NOVARTIS CARIBE SA
Agent Code	COL
Agent Name	COLLINS LTD
Benefit	B
Benefit Cat Code	Anti-Glaucoma
Drug Contract Start Date	2024-04-01
Drug Contract End Date	2024-06-17
Restrict To Ophthalmologist
Restrict To Pulmonologist
SIGCode
SIGFactor
Dentist Allowed	N
Therapeutic Code	524012
Therapeutic Desc	EENT CARBONIC ANHYDRASE INHIBITORS
Status Description
Default Route	OPHTHALMIC
Max Repeats	6
Therapeutic Head	EENT CARBONIC ANHYDRASE INHIBITORS
Amend Date	2024-05-06