Drugs available on Contract - [ATAZANAVIR|RITONAVIR 300MG|100MG TA], []

Contract Number	42
Brand Code	A681HD
Brand Name	ATAZANAVIR\|RITONAVIR 300MG\|100MG TA
Active Ingredient	ATAZANAVIR\|RITONAVIR
Trade Name	ATAZANAVIR\|RITONAVIR
Package Size	30'S
Formulary Category	BL
Pkg Price	61.16
Unit Price	2.04
Strength	300MG\|100MG
Unit Description	TAB
Max. Reimbursable Quantity / Month	60
Package Description	BOTT
Manufacturer Code	MAT
Manufacturer Name	MYLAN LABORATORIES
Agent Code	AHI
Agent Name	ARMSTRONG HEALTHCARE INC
Benefit
Benefit Cat Code
Drug Contract Start Date	2026-04-01
Drug Contract End Date	2028-03-31
Restrict To Ophthalmologist	No
Restrict To Pulmonologist	No
SIGCode
SIGFactor
Dentist Allowed	N
Therapeutic Code	08180820
Therapeutic Desc	NRTI
Status Description
Default Route	ORAL
Max Repeats	0
Therapeutic Head	NRTI
Amend Date